Provider Demographics
NPI:1154977361
Name:HAVEY, ERIC (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:HAVEY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 NE 22ND ST APT 609
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5183
Mailing Address - Country:US
Mailing Address - Phone:712-541-1890
Mailing Address - Fax:
Practice Address - Street 1:3183 SW 38TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1528
Practice Address - Country:US
Practice Address - Phone:305-501-0231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist