Provider Demographics
NPI:1326928003
Name:PANAVELIL, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:PANAVELIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5970 S JOG RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6576
Mailing Address - Country:US
Mailing Address - Phone:561-432-3693
Mailing Address - Fax:
Practice Address - Street 1:5970 S JOG RD STE A
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6576
Practice Address - Country:US
Practice Address - Phone:561-432-3693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist