Provider Demographics
NPI:1013947977
Name:SAVRAN, JEFFREY G (DPM)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:G
Last Name:SAVRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9858 GLADES RD STE D5
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3982
Mailing Address - Country:US
Mailing Address - Phone:561-852-8950
Mailing Address - Fax:561-883-9965
Practice Address - Street 1:9858 GLADES RD
Practice Address - Street 2:D5
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3983
Practice Address - Country:US
Practice Address - Phone:561-852-8950
Practice Address - Fax:561-883-9965
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1202213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0296228-00Medicaid
FL87633YOtherINDIVIDUAL PIN
FL406480526OtherRAILROAD MEDICARE
FLT55481Medicare UPIN
FL39575Medicare PIN
FL0296228-00Medicaid