Provider Demographics
NPI:1316965353
Name:YASKIN, INNA (DO)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:YASKIN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SUNNY ISLES BLVD STE 8A
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4680
Mailing Address - Country:US
Mailing Address - Phone:732-691-7599
Mailing Address - Fax:
Practice Address - Street 1:202 SUNNY ISLES BLVD STE 8A
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4680
Practice Address - Country:US
Practice Address - Phone:732-691-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17694207R00000X
CA20A11338207RG0300X
FLOS17694207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFB723AMedicare PIN
I25637Medicare UPIN
CAEO119YMedicare PIN