Healthcare Provider Details

I. General information

NPI: 1598407504
Provider Name (Legal Business Name): HENRY YELKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16699 COLLINS AVE APT 3006
SUNNY ISLES BEACH FL
33160-5420
US

IV. Provider business mailing address

16699 COLLINS AVE APT 3007
SUNNY ISLES BEACH FL
33160-5420
US

V. Phone/Fax

Practice location:
  • Phone: 347-735-3312
  • Fax:
Mailing address:
  • Phone: 347-735-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6949
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02009166A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberW7165
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37262
License Number StateMS
# 5
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS24067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: