Healthcare Provider Details

I. General information

NPI: 1356444830
Provider Name (Legal Business Name): DAVID ALAN LEVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7106 NW 11TH PL
GAINESVILLE FL
32605-3157
US

IV. Provider business mailing address

401 SW 88TH TERRACE
GAINESVILLE FL
32607-1452
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-2020
  • Fax: 352-331-2019
Mailing address:
  • Phone: 352-331-2020
  • Fax: 352-331-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0070513
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: