Provider Demographics
NPI:1689106098
Name:VOIN, VLAD
Entity Type:Individual
Prefix:
First Name:VLAD
Middle Name:
Last Name:VOIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10744 SEA CLIFF CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6355
Mailing Address - Country:US
Mailing Address - Phone:206-334-8399
Mailing Address - Fax:
Practice Address - Street 1:670 GLADES RD
Practice Address - Street 2:SUITE 400
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6461
Practice Address - Country:US
Practice Address - Phone:561-955-2570
Practice Address - Fax:561-955-2572
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL145276207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program