Provider Demographics
NPI:1821041112
Name:HAWRILYK, VOLODIMIR (MD)
Entity type:Individual
Prefix:DR
First Name:VOLODIMIR
Middle Name:
Last Name:HAWRILYK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VLADIMIR
Other - Middle Name:
Other - Last Name:HAVRYLIUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13714 BROMLEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2634
Mailing Address - Country:US
Mailing Address - Phone:904-220-9448
Mailing Address - Fax:
Practice Address - Street 1:8818 ARLINGTON EXPY
Practice Address - Street 2:B
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-8071
Practice Address - Country:US
Practice Address - Phone:904-221-0014
Practice Address - Fax:904-221-9189
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH79187Medicare UPIN
FL57838Medicare ID - Type Unspecified