Provider Demographics
NPI:1851451538
Name:KLAVINS, SCOTT EDWARD (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EDWARD
Last Name:KLAVINS
Suffix:
Gender:M
Credentials:MS, PT
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5113 PRAIRE DUNES VILLAGE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 SW 94TH TERRACE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2431
Practice Address - Country:US
Practice Address - Phone:954-701-0528
Practice Address - Fax:954-473-6021
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPT18855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9255YMedicare ID - Type UnspecifiedPHYSICAL THERAPY