Healthcare Provider Details

I. General information

NPI: 1992174239
Provider Name (Legal Business Name): KAMILYA N DVOYASHKINA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAMILYA BOROVIK PA-C

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

IV. Provider business mailing address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3508
  • Fax:
Mailing address:
  • Phone: 407-821-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9108923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: