MEDICARE: AMBER LEVENS

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	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659022101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LEVENS

Provider Business Mailing Address
First Line	:	1505 WAKEFIELD DR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-2327
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5120 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-2531
Country	:	US
Telephone Number	:	813-440-4933
Fax Number	:

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	03/12/2026

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Directions to “ AMBER LEVENS ” Practice Location

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