MEDICARE: ISRAEL KOROBKIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	101434	CA
2	122300000X	Dentist	DN28427	FL

General Provider Information

NPI Number	:	1164883997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISRAEL KOROBKIN

Provider Business Mailing Address
First Line	:	7723 VILLA NOVA DR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-1026
Country	:	US
Telephone Number	:	347-813-7266
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301A W PALMETTO PARK RD STE 203A
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3403
Country	:	US
Telephone Number	:	347-813-7266
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	04/09/2025

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