Provider Demographics
NPI:1801463591
Name:DIMITROV, DIMITAR (PT)
Entity type:Individual
Prefix:DR
First Name:DIMITAR
Middle Name:
Last Name:DIMITROV
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 EDEN ISLE BLVD NE APT 62
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1711
Mailing Address - Country:US
Mailing Address - Phone:850-313-6972
Mailing Address - Fax:
Practice Address - Street 1:3944 FLORIDA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2271
Practice Address - Country:US
Practice Address - Phone:561-786-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist