MEDICARE: YEHUDA A. MICHELOV 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	207X00000X	Orthopaedic Surgery Physician	272976	NY
2	207X00000X	Orthopaedic Surgery Physician	2884	WV
3	207X00000X	Orthopaedic Surgery Physician	OS13567	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	:	1902037468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEHUDA A. MICHELOV DO

Provider Business Mailing Address
First Line	:	PO BOX 816759
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33081-0759
Country	:	US
Telephone Number	:	954-964-2450
Fax Number	:	954-964-6084

Provider Business Practice Location Address
First Line	:	1100 S STATE ROAD 7 STE 201
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33068-4033
Country	:	US
Telephone Number	:	754-229-6886
Fax Number	:	754-229-6870

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

Provider Enumeration Date	:	07/31/2009
Last Update Date	:	01/31/2020

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