Provider Demographics
NPI:1992726871
Name:MASLYAK, SVETLANA (MD)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:MASLYAK
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 1:3990 SHERIDAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3661
Mailing Address - Country:US
Mailing Address - Phone:954-505-4458
Mailing Address - Fax:954-367-3495
Practice Address - Street 1:3990 SHERIDAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3661
Practice Address - Country:US
Practice Address - Phone:954-505-4458
Practice Address - Fax:954-367-3495
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96165207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35406OtherWELLCARE
FL9284660OtherCIGNA
FL35406OtherSTAYWELL
FL276489000Medicaid
FL35406OtherHEALTHEASE
FLSG81122OtherVISTA
FLI72811Medicare UPIN