Provider Demographics
NPI:1730909599
Name:YAIKOVA, NATALIA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:YAIKOVA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6097 BALBOA CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8166
Mailing Address - Country:US
Mailing Address - Phone:786-800-8292
Mailing Address - Fax:
Practice Address - Street 1:323 SE 23RD AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7234
Practice Address - Country:US
Practice Address - Phone:561-737-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9119297363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant