Individual
BORIS HAVKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3021 W EAU GALLIE BLVD, MELBOURNE, FL 32934-7005
(321) 500-4545
(321) 425-4000
Mailing address
3021 W EAU GALLIE BLVD STE 103, MELBOURNE, FL 32934-7005
(321) 500-4545
(321) 425-4000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME90111
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269433600
—
FL
01
—
37966
BCBS
FL
01
—
P01164118
RR MEDICARE
FL
Enumeration date
10/31/2005
Last updated
06/05/2019
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