Healthcare Provider Details

I. General information

NPI: 1659128718
Provider Name (Legal Business Name): HARUTYUN DAVTYAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 WESTON RD
WESTON FL
33331-3602
US

IV. Provider business mailing address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax:
Mailing address:
  • Phone: 954-498-4976
  • Fax: 954-498-4976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: