Healthcare Provider Details

I. General information

NPI: 1629273214
Provider Name (Legal Business Name): MELISSA LEVACK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 LINTON BLVD STE 100
DELRAY BEACH FL
33484-6514
US

IV. Provider business mailing address

5352 LINTON BLVD STE 100
DELRAY BEACH FL
33484-6514
US

V. Phone/Fax

Practice location:
  • Phone: 561-638-9140
  • Fax: 561-404-5035
Mailing address:
  • Phone: 561-638-9140
  • Fax: 561-404-5035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberDR.0071563
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberEMC0007326
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL-231921
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME177975
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number14226449-1235
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number56241
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDR.0071563
License Number StateCO
# 8
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number105549
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: