DR. VITALY BORODIN M.D. NPI 1659702553

NPI Information

NPI: 1659702553
Provider Name: DR. VITALY BORODIN, M.D.
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Organization: FLORIDA WOMAN CARE LLC

PECOS Registration: Yes

Address:
5481 W WATERS AVE
TAMPA, FL
ZIP 33634
Phone: (484) 350-7158
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DR. Vitaly Borodin, M.D. is a student in an organized health care education training program in Tampa, FL with 22 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Vitaly Borodin, M.D. NPI is 1659702553. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5481 W WATERS AVE
TAMPA, FL
ZIP 33634-205
Phone: (484) 350-7158

The NPI 1659702553 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/3/2013 and was last updated on 4/5/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207ZC0500X	Pathology	Cytopathology	ME135873	FLORIDA	No
2	207ZP0007X	Pathology	Molecular Genetic Pathology	0116028958	VIRGINIA	No
3	207ZP0007X	Pathology	Molecular Genetic Pathology	ME135873	FLORIDA	No
4	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	MT201400	PENNSYLVANIA	No
5	207ZP0102X	Pathology	Anatomic Pathology & Clinical Pathology	ME135873	FLORIDA	No
6	390200000X	Student in an Organized Health Care Education/Training Program		0116028958	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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