Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | OS14450 | FL |
N | 207RC0000X | Internist - Cardiovascular Disease | 9759853-1204 | UT |
NPI | 1003120692 |
---|---|
Provider Name | Andrija Vidic |
First Address | Orlando, FL 32804-5521 |
Second Address | Orlando, FL 32804-5521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2010 |
Last Update Date | 17/03/2018 |