MEDICARE: JONATHAN SCOTT LEVINE 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	208600000X	Surgery Physician	ME 42654	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001401391	OTHER	FL	UNITED HEALTH CARE
2	1711423	OTHER	FL	CIGNA
3	243332	OTHER	FL	AVMED
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548283393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SCOTT LEVINE M.D.

Provider Business Mailing Address
First Line	:	4801 N FEDERAL HWY
Second Line	:	SUITE # 101
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4618
Country	:	US
Telephone Number	:	954-202-0242
Fax Number	:	954-202-0243

Provider Business Practice Location Address
First Line	:	4801 N FEDERAL HWY
Second Line	:	SUITE # 101
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-4618
Country	:	US
Telephone Number	:	954-202-0242
Fax Number	:	954-202-0243

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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