Provider Demographics
NPI:1265960249
Name:BINAYEV, IZOLDA
Entity type:Individual
Prefix:
First Name:IZOLDA
Middle Name:
Last Name:BINAYEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 S OCEAN DR APT 1006
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5910
Mailing Address - Country:US
Mailing Address - Phone:718-450-4684
Mailing Address - Fax:
Practice Address - Street 1:1904 S OCEAN DR APT 1006
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5910
Practice Address - Country:US
Practice Address - Phone:718-450-4684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist