MEDICARE: LYUDMILA YUZEFOVICH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME62099	FL
2	2084P0800X	Psychiatry Physician	25MA04063900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396834164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYUDMILA YUZEFOVICH MD

Provider Business Mailing Address
First Line	:	4740 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5839
Country	:	US
Telephone Number	:	954-486-4005
Fax Number	:	954-497-3857

Provider Business Practice Location Address
First Line	:	330 SW 27TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2051
Country	:	US
Telephone Number	:	954-791-4300
Fax Number	:	954-497-3857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	03/08/2018

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