MEDICARE: ARTHUR KHARONOV

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	363LF0000X	Family Nurse Practitioner	APRN11006992	FL
2	363LF0000X	Family Nurse Practitioner	F340565	NY
3	363LF0000X	Family Nurse Practitioner	26NJ00675300	NJ

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	:	1992258164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR KHARONOV

Provider Business Mailing Address
First Line	:	109 AMBERSWEET WAY STE 642
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33897-8418
Country	:	US
Telephone Number	:	732-599-0690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 BOWMAN ST
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-3144
Country	:	US
Telephone Number	:	732-599-0690
Fax Number	:

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

Provider Enumeration Date	:	07/25/2016
Last Update Date	:	12/30/2025

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