MEDICARE: MEDBETTER HEALTH PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103T00000X	Psychologist
2	207Q00000X	Family Medicine Physician
3	2084P0800X	Psychiatry Physician
4	208VP0000X	Pain Medicine Physician
5	207R00000X	Internal Medicine Physician

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	:	1447828561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDBETTER HEALTH PA

Provider Business Mailing Address
First Line	:	3100 RAY FERRERO JR BLVD STE 5031A
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-1013
Country	:	US
Telephone Number	:	305-339-1756
Fax Number	:	646-974-9264

Provider Business Practice Location Address
First Line	:	3100 RAY FERRERO JR BLVD
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-1013
Country	:	US
Telephone Number	:	305-339-1756
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIK ILYAYEV
Credential	:	MD
Telephone Number	:	786-802-5942

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	07/24/2023

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Directions to “MEDBETTER HEALTH PA ” Practice Location

Language	Start Address	Practice Location

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