MEDICARE: JOCELYN E. LEVEQUE, MD PL

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	2086S0122X	Plastic and Reconstructive Surgery Physician	ME0079633	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	97105	OTHER	FL	BC/BS OF FL GROUP #

General Provider Information

NPI Number	:	1982644126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOCELYN E. LEVEQUE, MD PL

Provider Business Mailing Address
First Line	:	350 PENSACOLA BEACH BLVD.
Second Line	:	SUITE B
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-4882
Country	:	US
Telephone Number	:	850-934-8893
Fax Number	:	850-934-8858

Provider Business Practice Location Address
First Line	:	350 PENSACOLA BEACH BLVD.
Second Line	:	SUITE B
City	:	GULF BREEZE
State	:	FL
Zip	:	32561-4882
Country	:	US
Telephone Number	:	850-934-8893
Fax Number	:	850-934-8858

Authorized Official
Title or Position	:	OWNER
Name	:	JOCELYN E LEVEQUE
Credential	:	M.D.
Telephone Number	:	850-934-8893

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/22/2020

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