Provider Demographics
NPI:1194819524
Name:JAVATE, EMANUEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:L
Last Name:JAVATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EMANUEL
Other - Middle Name:L
Other - Last Name:JAVATE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6700 CROSSWINDS DR N
Mailing Address - Street 2:SUITE 200-A
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8602
Mailing Address - Country:US
Mailing Address - Phone:727-344-4651
Mailing Address - Fax:727-347-6224
Practice Address - Street 1:6700 CROSSWINDS DR NO
Practice Address - Street 2:SUITE 200-A
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710
Practice Address - Country:US
Practice Address - Phone:727-344-4651
Practice Address - Fax:727-347-6224
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-107011207V00000X
FLME102811207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I03227Medicare UPIN