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NPI Code Detail

MEDICARE: ANATOLY MITROKHIN M.D.

MEDICARE: ANATOLY MITROKHIN M.D.
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
1207L00000XAnesthesiology Physician312814NY
2207L00000XAnesthesiology PhysicianME153212FL
3204F00000XTransplant Surgery Physician60662744WA
4208D00000XGeneral Practice Physician312814NY
5208D00000XGeneral Practice Physician153212FL

Other Identifiers

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

General Provider Information

NPI Number : 1376097238
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANATOLY MITROKHIN M.D.
Provider Business Mailing Address
First Line : 450 CLARKSON AVENUE, BOX 1262
Second Line :
City : BROOKLYN
State : NY
Zip : 11203
Country : US
Telephone Number : 718-270-8867
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-3003
Country : US
Telephone Number : 352-273-8610
Fax Number : 352-273-8612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2016
Last Update Date : 03/10/2026

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