Healthcare Provider Details

I. General information

NPI: 1629713649
Provider Name (Legal Business Name): LAYLAH JAVED DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6447 LAKE WORTH RD
GREENACRES FL
33463-3007
US

IV. Provider business mailing address

15690 BOEING CT
WELLINGTON FL
33414-8384
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax: 561-277-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO4704
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO4704
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPO4704
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO4704
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberPO4704
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: