Provider Demographics
NPI:1902037468
Name:MICHELOV, YEHUDA A (DO)
Entity Type:Individual
Prefix:
First Name:YEHUDA
Middle Name:A
Last Name:MICHELOV
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 816759
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33081-0759
Mailing Address - Country:US
Mailing Address - Phone:954-964-2450
Mailing Address - Fax:954-964-6084
Practice Address - Street 1:1100 S STATE ROAD 7 STE 201
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-4033
Practice Address - Country:US
Practice Address - Phone:754-229-6886
Practice Address - Fax:754-229-6870
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY272976207X00000X
WV2884207X00000X
FLOS13567207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery