Provider Demographics
NPI:1073686515
Name:GOLBRAYKH, YEVGENIYA (MD)
Entity Type:Individual
Prefix:
First Name:YEVGENIYA
Middle Name:
Last Name:GOLBRAYKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 COLLINS AVE
Mailing Address - Street 2:#216
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:305-945-9595
Mailing Address - Fax:305-945-9545
Practice Address - Street 1:17100 COLLINS AVE
Practice Address - Street 2:#216
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-945-9595
Practice Address - Fax:305-945-9545
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81951208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5783Medicare ID - Type Unspecified
FLK5783Medicare PIN
E5451Medicare PIN
H38200Medicare UPIN
FLE5451BMedicare PIN