Provider Demographics
NPI:1447453824
Name:ARKADIY V. PURYGIN, M.D., D.O., P.A.
Entity type:Organization
Organization Name:ARKADIY V. PURYGIN, M.D., D.O., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARKADIY
Authorized Official - Middle Name:V
Authorized Official - Last Name:PURYGIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-535-0055
Mailing Address - Street 1:4308 ALTON RD STE 880
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4560
Mailing Address - Country:US
Mailing Address - Phone:305-535-0055
Mailing Address - Fax:844-364-0130
Practice Address - Street 1:4308 ALTON RD STE 880
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4560
Practice Address - Country:US
Practice Address - Phone:305-535-0055
Practice Address - Fax:844-364-0130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9336207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2728231 00Medicaid
FL29414OtherBCBS
FL29414AOtherMEDICARE
FL29414AOtherMEDICARE