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General NPI Number Information
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NPI Number | 1215967567
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Entity Type | Individual
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Provider Name | YURI N SKARLAT PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 04/02/2023
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Provider Practice Location Address
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Address Line | 2100 E HALLANDALE BEACH BLVD STE 404
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3772
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Country | US
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Telephone | 786-288-3661
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Fax | 949-798-7917
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Provider Business Mailing Address
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Address Line | 2100 E HALLANDALE BEACH BLVD STE 404
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3772
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Country | US
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Telephone | 786-288-3661
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Fax | 949-798-7917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 9103410
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 14392
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14392
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License Number State | CA
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