Provider Demographics
NPI:1215967567
Name:SKARLAT, YURI N (PA-C)
Entity type:Individual
Prefix:
First Name:YURI
Middle Name:N
Last Name:SKARLAT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:YURY
Other - Middle Name:N
Other - Last Name:SKARLAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2100 E HALLANDALE BEACH BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3772
Mailing Address - Country:US
Mailing Address - Phone:786-288-3661
Mailing Address - Fax:949-798-7917
Practice Address - Street 1:2100 E HALLANDALE BEACH BLVD STE 404
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3772
Practice Address - Country:US
Practice Address - Phone:786-288-3661
Practice Address - Fax:949-798-7917
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103410363A00000X
CA14392363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical