Provider Demographics
NPI:1295738938
Name:JAVEED, HAYATH (MD)
Entity type:Individual
Prefix:
First Name:HAYATH
Middle Name:
Last Name:JAVEED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 MOOG RD
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34690-1857
Mailing Address - Country:US
Mailing Address - Phone:727-944-5055
Mailing Address - Fax:727-942-0486
Practice Address - Street 1:4904 MOOG RD
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34690-1857
Practice Address - Country:US
Practice Address - Phone:727-944-5055
Practice Address - Fax:727-942-0486
Is Sole Proprietor?:No
Enumeration Date:2005-05-26
Last Update Date:2015-02-02
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-21
Provider Licenses
StateLicense IDTaxonomies
FLME71161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257115300Medicaid
FL257115300Medicaid
FL32147BMedicare ID - Type Unspecified