Provider Demographics
NPI:1720668858
Name:JHAVERI, HASAN FAIYAAZ
Entity Type:Individual
Prefix:
First Name:HASAN
Middle Name:FAIYAAZ
Last Name:JHAVERI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9134 GREAT HERON CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5487
Mailing Address - Country:US
Mailing Address - Phone:407-876-1669
Mailing Address - Fax:
Practice Address - Street 1:1104 NEWELL DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3011
Practice Address - Country:US
Practice Address - Phone:863-206-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program