Healthcare Provider Details

I. General information

NPI: 1043203003
Provider Name (Legal Business Name): JEREMY D HAVAS D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 SW 33RD RD STE 301
OCALA FL
34474-8425
US

IV. Provider business mailing address

PO BOX 2463
CRYSTAL RIVER FL
34423-2463
US

V. Phone/Fax

Practice location:
  • Phone: 352-554-4878
  • Fax: 833-340-7254
Mailing address:
  • Phone: 352-795-5628
  • Fax: 352-795-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0007352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: