MEDICARE: BRIAN K YORKGITIS DO

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	208600000X	Surgery Physician	OT013129	PA
2	208600000X	Surgery Physician	257973	MA
3	2086S0102X	Surgical Critical Care Physician	02008040A	IN
4	2086S0102X	Surgical Critical Care Physician	OS13802	FL
5	363A00000X	Physician Assistant	MA051179	PA
6	363A00000X	Physician Assistant	COOO2694	MD
7	208600000X	Surgery Physician	OS13802	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255379079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN K YORKGITIS DO

Provider Business Mailing Address
First Line	:	PO BOX 100108
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0108
Country	:	US
Telephone Number	:	352-273-5670
Fax Number	:	352-273-5683

Provider Business Practice Location Address
First Line	:	311 N CLYDE MORRIS BLVD STE 510
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2757
Country	:	US
Telephone Number	:	386-241-1020
Fax Number	:	386-241-1022

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	11/14/2024

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Directions to “ BRIAN K YORKGITIS DO” Practice Location

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