Provider Demographics
NPI:1265946875
Name:MASHKIN, INC.
Entity type:Organization
Organization Name:MASHKIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P, VP, S, T
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAIPOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-458-5098
Mailing Address - Street 1:220 THREE ISLANDS BLVD APT 108
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7325
Mailing Address - Country:US
Mailing Address - Phone:305-458-5098
Mailing Address - Fax:
Practice Address - Street 1:2225 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3611
Practice Address - Country:US
Practice Address - Phone:954-962-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2019-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1338992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty