Provider Demographics
NPI:1881883577
Name:YOAV, BARNAVON, MD, PA
Entity type:Organization
Organization Name:YOAV, BARNAVON, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOAV
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMAVON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-987-8100
Mailing Address - Street 1:1201 N 35 AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5468
Mailing Address - Country:US
Mailing Address - Phone:954-987-8100
Mailing Address - Fax:954-989-0160
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5468
Practice Address - Country:US
Practice Address - Phone:954-987-8100
Practice Address - Fax:954-989-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047713174400000X
2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378408800Medicaid
FLG09343Medicare UPIN
FL17809Medicare PIN
FL27466Medicare PIN
FL378408800Medicaid