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General NPI Number Information
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NPI Number | 1982728705
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Entity Type | Individual
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Provider Name | DIANA GOROKHOVSKY D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 8767 BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4479
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Country | US
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Telephone | 561-734-5484
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Fax | 561-734-5485
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Provider Business Mailing Address
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Address Line | 8767 BOYNTON BEACH BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-4479
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Country | US
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Telephone | 615-734-5484
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Fax | 561-734-5485
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 9963
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License Number State | FL
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