MEDICARE: LARRY P LEVIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	FLME0048220	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02728	OTHER	FL	BLUE CROSS BLUE SHIELD
2	245357	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1134109325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY P LEVIN M.D.

Provider Business Mailing Address
First Line	:	673 LAKEWOODE CIR W
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-4315
Country	:	US
Telephone Number	:	561-865-0331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 CLINT MOORE RD
Second Line	:	STE. 125
City	:	BOCA RATON
State	:	FL
Zip	:	33487-2768
Country	:	US
Telephone Number	:	561-939-0800
Fax Number	:	561-939-0820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	10/01/2007

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