Healthcare Provider Details

I. General information

NPI: 1760046940
Provider Name (Legal Business Name): YUYA BURKHART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 N PARK RD
PLANT CITY FL
33563-2026
US

IV. Provider business mailing address

17 DAVIS BLVD STE 308
TAMPA FL
33606-3438
US

V. Phone/Fax

Practice location:
  • Phone: 813-757-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1760046940
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME150226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: