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General NPI Number Information
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NPI Number | 1982659710
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Entity Type | Individual
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Provider Name | BRIAN PAVLAS DPM
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 4821 SW 64TH CT
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City | MIAMI
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State | FL
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Zip | 33155-6105
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Country | US
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Telephone | 786-999-4840
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Fax | 305-356-7150
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Provider Business Mailing Address
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Address Line | 4821 SW 64TH CT
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City | MIAMI
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State | FL
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Zip | 33155-6105
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Country | US
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Telephone | 786-999-4840
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Fax | 305-356-7150
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3232
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License Number State | FL
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