Provider Demographics
NPI:1255379079
Name:YORKGITIS, BRIAN K (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:YORKGITIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100108
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0108
Mailing Address - Country:US
Mailing Address - Phone:352-273-5670
Mailing Address - Fax:352-273-5683
Practice Address - Street 1:311 N CLYDE MORRIS BLVD STE 510
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2757
Practice Address - Country:US
Practice Address - Phone:386-241-1020
Practice Address - Fax:386-241-1022
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT013129208600000X
MA257973208600000X
IN02008040A2086S0102X
FLOS138022086S0102X, 208600000X
PAMA051179363A00000X
MDCOOO2694363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017421600Medicaid
FLIO924ZMedicare PIN
FL017421600Medicaid