Provider Demographics
NPI:1598286353
Name:IAKYMENKO, OLEKSII (MD)
Entity Type:Individual
Prefix:MR
First Name:OLEKSII
Middle Name:
Last Name:IAKYMENKO
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 1:210 S.W. 11ST, APT. # 302
Mailing Address - Street 2:PALM GRADENS
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130
Mailing Address - Country:US
Mailing Address - Phone:239-565-8801
Mailing Address - Fax:
Practice Address - Street 1:1611 N.W. 12TH AVE, ROOM #2044
Practice Address - Street 2:HOLTZ CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-8381
Practice Address - Fax:305-585-2598
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036166147207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program