Healthcare Provider Details

I. General information

NPI: 1215979901
Provider Name (Legal Business Name): CYNTHIA LEVY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA LEVY

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW 12TH AVE
MIAMI FL
33136-1051
US

IV. Provider business mailing address

1500 NW 12TH AVE
MIAMI FL
33136-1051
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-5757
  • Fax:
Mailing address:
  • Phone: 305-243-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME84051
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberME84051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: