Provider Demographics
NPI:1164535100
Name:CAVALARIS, JOY G (MD)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:G
Last Name:CAVALARIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOY
Other - Middle Name:G
Other - Last Name:CAVALARIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:4671 S CONGRESS AVE
Practice Address - Street 2:SUITE 100 B
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4783
Practice Address - Country:US
Practice Address - Phone:561-434-0111
Practice Address - Fax:561-434-4868
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90488207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272505300Medicaid
FLLM907OtherMEDICARE
FLI29791Medicare UPIN