Healthcare Provider Details

I. General information

NPI: 1730125170
Provider Name (Legal Business Name): MOHAMMAD T JAVED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6447 LAKE WORTH RD
GREENACRES FL
33463-3007
US

IV. Provider business mailing address

6447 LAKE WORTH RD
GREENACRES FL
33463-3007
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-1700
  • Fax: 561-642-7587
Mailing address:
  • Phone: 561-433-1700
  • Fax: 561-642-7587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberME0071079
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: