Individual
MIKHAILIA WANAKEE LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1625 SE 3RD AVE STE 620, FORT LAUDERDALE, FL 33316-2521
(954) 320-3380
(954) 320-3371
Mailing address
1608 SE 3RD AVE FL 3, FORT LAUDERDALE, FL 33316-2564
(954) 320-3380
(954) 320-3371
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME 112403
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119118000
—
FL
Enumeration date
04/28/2008
Last updated
07/29/2025
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