Provider Demographics
NPI:1477747970
Name:VERBINSKAYA, NATALYA A (MD)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:A
Last Name:VERBINSKAYA
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 1:4875 PALM COAST PKWY N.W.
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137
Mailing Address - Country:US
Mailing Address - Phone:386-597-2877
Mailing Address - Fax:386-597-2878
Practice Address - Street 1:4875 PALM COAST PKWY N.W.
Practice Address - Street 2:UNIT 1
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137
Practice Address - Country:US
Practice Address - Phone:386-597-2877
Practice Address - Fax:386-597-2878
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279255900Medicaid
FL02584OtherBLUE CROSS BLUE SHIELD
FL02584OtherBLUE CROSS BLUE SHIELD