Healthcare Provider Details

I. General information

NPI: 1114180593
Provider Name (Legal Business Name): JEFFREY A LEVY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIPLOMAT PARKWAY
HOLLYWOOD FL
33019
US

IV. Provider business mailing address

1600 DIPLOMAT PARKWAY
HOLLYWOOD FL
33019
US

V. Phone/Fax

Practice location:
  • Phone: 954-483-4160
  • Fax: 305-937-4888
Mailing address:
  • Phone: 954-483-4160
  • Fax: 305-937-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFREY A LEVY
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 954-483-4160