Provider Demographics
NPI:1801086426
Name:SAVOV, JORDAN DIMITROV (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:DIMITROV
Last Name:SAVOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2183
Mailing Address - Country:US
Mailing Address - Phone:239-430-0845
Mailing Address - Fax:888-934-2737
Practice Address - Street 1:1629 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-2183
Practice Address - Country:US
Practice Address - Phone:239-430-0845
Practice Address - Fax:888-934-2737
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99799208M00000X, 207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME99799OtherFLORIDA MEDICAL LICENSE