Marina Mikitchuk, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

9109430 Issued in FL

Practice address

10 E Palmetto Park Rd
Boca Raton, FL 33432-4864

Phone

(718) 996-1448

NPI assigned

May 8, 2009

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1861626632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 NW 13TH ST STE 201",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862269",
            "telephone_number": "561-955-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E PALMETTO PARK RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334324864",
            "telephone_number": "718-996-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKITCHUK",
        "first_name": "MARINA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "013207",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9109430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethe Midler, RBT
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• Laura Miguel Alonso
• Sierra Tyler Mihovich, MSW
• Mongi Gadall Mikhail, DDS
• Mikayela Mikulinsky, PT
• Melissa Milan Ferrer
• Stephen Daniel Milan, M.D.
• May Naraporn Milazzo, NP
• Robert Anthony Milbut Jr., R.N.F.A.

• Surgical Physician Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.