Provider Demographics
NPI:1982728705
Name:GOROKHOVSKY, DIANA (DO)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:GOROKHOVSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8767 BOYNTON BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4479
Mailing Address - Country:US
Mailing Address - Phone:615-734-5484
Mailing Address - Fax:561-734-5485
Practice Address - Street 1:8767 BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-4479
Practice Address - Country:US
Practice Address - Phone:561-734-5484
Practice Address - Fax:561-734-5485
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine