Healthcare Provider Details

I. General information

NPI: 1255730560
Provider Name (Legal Business Name): HAVOVI B SHROFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22047 STATE ROAD 7
BOCA RATON FL
33428-4219
US

IV. Provider business mailing address

11761 ISLAND LAKES LN
BOCA RATON FL
33498-6804
US

V. Phone/Fax

Practice location:
  • Phone: 561-800-2527
  • Fax: 561-477-1556
Mailing address:
  • Phone: 561-703-1878
  • Fax: 561-477-1556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMH11982
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH11982
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: