Provider Demographics
NPI:1831178698
Name:HAIM, YITZHAK D (MD)
Entity type:Individual
Prefix:DR
First Name:YITZHAK
Middle Name:D
Last Name:HAIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANI
Other - Middle Name:
Other - Last Name:HAIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:326 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5734
Mailing Address - Country:US
Mailing Address - Phone:407-841-1100
Mailing Address - Fax:407-649-8677
Practice Address - Street 1:1115 E RIDGEWOOD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5443
Practice Address - Country:US
Practice Address - Phone:407-841-1100
Practice Address - Fax:407-841-0774
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69117207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250306900Medicaid
FLE77366Medicare UPIN
FL27886Medicare PIN