Individual
DR. FAIYAAZ MUSTANSIR JHAVERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 PARK PLACE BLVD STE A, DAVENPORT, FL 33837-6870
(863) 419-2165
(863) 419-2166
Mailing address
105 PARK PLACE BLVD STE A, DAVENPORT, FL 33837-6870
(863) 419-2165
(863) 419-2166
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0080612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164139
STAYWELL
FL
01
—
217235
AMERIGROUP
FL
01
—
340018541
RAILROAD MEDICARE
FL
01
—
35713
BCBS
FL
Enumeration date
08/07/2006
Last updated
01/19/2022
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