MEDICARE: HAYATH JAVEED MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ME 71161	FL

General Provider Information

NPI Number	:	1558510602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYATH JAVEED MD PA

Provider Business Mailing Address
First Line	:	4904 MOOG RD
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-1857
Country	:	US
Telephone Number	:	172-794-4505
Fax Number	:	172-794-2048

Provider Business Practice Location Address
First Line	:	4904 MOOG RD
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-1857
Country	:	US
Telephone Number	:	172-794-4505
Fax Number	:	172-794-2048

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HAYATH JAVEED
Credential	:	M.D
Telephone Number	:	17279445055

Provider Enumeration Date	:	09/13/2008
Last Update Date	:	09/13/2008

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