MEDICARE: STEPHANIE ORDONEZ LEVASSUER

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	363LC0200X	Critical Care Medicine Nurse Practitioner	11042884	FL
2	363LA2200X	Adult Health Nurse Practitioner	APRN11042884	FL

General Provider Information

NPI Number	:	1215804034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ORDONEZ LEVASSUER

Provider Business Mailing Address
First Line	:	14511 SW 17TH CT
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33325-5920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	305-585-1111
Fax Number	:

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

Provider Enumeration Date	:	10/17/2025
Last Update Date	:	12/29/2025

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