Healthcare Provider Details

I. General information

NPI: 1528886819
Provider Name (Legal Business Name): STEVEN SCOTT HLAVATY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 SW 109TH AVE
DAVIE FL
33328-4734
US

IV. Provider business mailing address

5540 SW 109TH AVE
DAVIE FL
33328-4734
US

V. Phone/Fax

Practice location:
  • Phone: 435-757-7750
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number29661
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: