Provider Demographics
NPI:1134634207
Name:HAZAN, ROYI (DPT)
Entity Type:Individual
Prefix:DR
First Name:ROYI
Middle Name:
Last Name:HAZAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 NORTH FEDERAL HIGHWAY
Mailing Address - Street 2:304
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-2459
Mailing Address - Country:US
Mailing Address - Phone:347-616-9079
Mailing Address - Fax:
Practice Address - Street 1:2700 N FEDERAL HWY APT 304
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-2460
Practice Address - Country:US
Practice Address - Phone:347-616-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist