Healthcare Provider Details

I. General information

NPI: 1518596287
Provider Name (Legal Business Name): VASANTI JHAVERI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2020
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 E CONFERENCE DR
BOCA RATON FL
33486-3148
US

IV. Provider business mailing address

363 E CONFERENCE DR
BOCA RATON FL
33486-3148
US

V. Phone/Fax

Practice location:
  • Phone: 561-306-5709
  • Fax:
Mailing address:
  • Phone: 561-306-5709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD486741
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: