Provider Demographics
NPI:1679293179
Name:MEDICAMENT LLC
Entity Type:Organization
Organization Name:MEDICAMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-932-5500
Mailing Address - Street 1:1605 SW 108TH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7171
Mailing Address - Country:US
Mailing Address - Phone:321-474-0902
Mailing Address - Fax:
Practice Address - Street 1:18305 BISCAYNE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2172
Practice Address - Country:US
Practice Address - Phone:305-932-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty