Healthcare Provider Details

I. General information

NPI: 1730617846
Provider Name (Legal Business Name): HOWARD LEVINE DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NW 12TH AVE
MIAMI FL
33128-1008
US

IV. Provider business mailing address

127 NW 12TH AVE
MIAMI FL
33128-1008
US

V. Phone/Fax

Practice location:
  • Phone: 305-325-1771
  • Fax: 305-325-1775
Mailing address:
  • Phone: 305-325-1771
  • Fax: 305-325-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDN3799
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN3799
License Number StateFL

VIII. Authorized Official

Name: HOWARD LEVINE
Title or Position: DENTIST/OWNER
Credential: D.D.S.
Phone: 305-325-1771