Provider Demographics
NPI:1336272830
Name:KEYSER, SVETLANA R (MD)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:R
Last Name:KEYSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17201 COLLINS AVE APT 1105
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3477
Mailing Address - Country:US
Mailing Address - Phone:831-601-7793
Mailing Address - Fax:
Practice Address - Street 1:17201 COLLINS AVE APT 1105
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3477
Practice Address - Country:US
Practice Address - Phone:831-601-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111705174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist