Healthcare Provider Details

I. General information

NPI: 1659672780
Provider Name (Legal Business Name): LEVINSON MEDICAL CENTER AT COOPER CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2010
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8673 STIRLING RD
COOPER CITY FL
33328-5902
US

IV. Provider business mailing address

8673 STIRLING RD
COOPER CITY FL
33328-5902
US

V. Phone/Fax

Practice location:
  • Phone: 954-874-7600
  • Fax:
Mailing address:
  • Phone: 954-874-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS5734
License Number StateFL

VIII. Authorized Official

Name: MRS. CATHERINE ELIZABETH LEVINSON
Title or Position: MGMR
Credential:
Phone: 954-874-7600