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General NPI Number Information
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NPI Number | 1598286353
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Entity Type | Individual
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Provider Name | OLEKSII IAKYMENKO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 1611 N.W. 12TH AVE, ROOM #2044 HOLTZ CENTER
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-8381
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Fax | 305-585-2598
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Provider Business Mailing Address
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Address Line | 210 S.W. 11ST, APT. # 302 PALM GRADENS
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City | MIAMI
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State | FL
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Zip | 33130
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Country | US
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Telephone | 239-565-8801
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036166147
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License Number State | IL
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