NPIMap

Individual provider Active NPI

Daniela Kassabov, MD

  • Family Medicine Physician
  • Lakewood Ranch, FL
National Provider Identifier
1811218613
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME116023 Issued in FL
Practice address
11505 Palmbrush TRL
Suite 220
Lakewood Ranch, FL 34202-2915
Phone
(941) 747-2090
Fax
(941) 556-7785
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11015346A IN
Family Medicine Physician 207Q00000X ME116023 FL Primary

Addresses

Primary practice location

11505 Palmbrush TRL
Suite 220
Lakewood Ranch, FL 34202-2915

Mailing address

PO Box 850001
Orlando, FL 32885-0001
Phone (941) 747-2090

Other names 1

  • Daniela Draganova Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130628000285 FL Practitioner - Family Practice 9133365398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Medical Specialists LLCGroup PAC ID 5799786687, 125 clinicians

Practice addresses (Care Compare)

11505 Palmbrush TRL
Suite 220
Lakewood Ranch, FL 34202-2915
Phone (941) 747-2090

3830 Bee Ridge Rd
Sarasota, FL 34233-1105

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11015346AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Specialists LLC CurrentSince Jul 1, 2013 Accepting new patients
Florida Medical Specialists LLC CurrentSince Jul 1, 2013 Accepting new patients
Best Value Healthcare LLC Past Accepting new patients
Florida Medical Specialists LLC Family Medicine Past Accepting new patients

Locations

4401 Cortez Rd W
Bradenton, FL 34210
Phone (941) 357-5550

11505 Palmbrush Trl
Ste 220
Lakewood Ranch, FL 34202
Phone (941) 747-2090

4451 Aidan Ln
Ste 201
North Port, FL 34287
Phone (941) 423-1111

3830 Bee Ridge Rd
Ste 100
Sarasota, FL 34233
Phone (941) 921-0383

3830 Bee Ridge Rd
Ste 301
Sarasota, FL 34233
Phone (941) 923-1872

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377043200000",
    "number": "1811218613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850001",
            "telephone_number": "941-747-2090",
            "fax_number": "941-556-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 PALMBRUSH TRL",
            "address_2": "SUITE 220",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022915",
            "telephone_number": "941-747-2090",
            "fax_number": "941-556-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSABOV",
        "first_name": "DANIELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2013-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11015346A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELA",
            "last_name": "DRAGANOVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.