Provider Demographics
NPI:1982008199
Name:MOHAMMAD T JAVED, MDPA
Entity Type:Organization
Organization Name:MOHAMMAD T JAVED, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-386-6832
Mailing Address - Street 1:3696 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3724
Mailing Address - Country:US
Mailing Address - Phone:561-969-1595
Mailing Address - Fax:561-969-1527
Practice Address - Street 1:3696 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3724
Practice Address - Country:US
Practice Address - Phone:561-969-1595
Practice Address - Fax:561-969-1527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071079261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care