Provider Demographics
NPI:1518009497
Name:REYBLAT, SVETLANA (PA-C, MPH)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:REYBLAT
Suffix:
Gender:F
Credentials:PA-C, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7318 PANACHE WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6921
Mailing Address - Country:US
Mailing Address - Phone:561-361-9420
Mailing Address - Fax:
Practice Address - Street 1:5258 LINTON BLVD STE 306
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6530
Practice Address - Country:US
Practice Address - Phone:561-498-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA-3743363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39811AOtherGROUP NUMBER
FLU2988YMedicare ID - Type Unspecified
FL39811AOtherGROUP NUMBER