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General NPI Number Information
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NPI Number | 1255891982
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Entity Type | Individual
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Provider Name | YEVGENIY KHARONOV DO
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 1150 NW 14TH ST STE 713
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City | MIAMI
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State | FL
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Zip | 33136-2118
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Country | US
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Telephone | 305-243-1579
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Fax | 305-243-3435
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Provider Business Mailing Address
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Address Line | 1150 NW 14TH ST STE 713
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City | MIAMI
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State | FL
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Zip | 33136-2118
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Country | US
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Telephone | 305-243-1579
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Fax | 305-243-3435
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1016458
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS21816
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License Number State | FL
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