Healthcare Provider Details

I. General information

NPI: 1851388201
Provider Name (Legal Business Name): JAY HARRIS LEVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 NE 168TH ST
NORTH MIAMI BEACH FL
33162-3412
US

IV. Provider business mailing address

184 NE 168TH ST
NORTH MIAMI BEACH FL
33162-3412
US

V. Phone/Fax

Practice location:
  • Phone: 305-655-0411
  • Fax: 305-655-0499
Mailing address:
  • Phone: 305-655-0411
  • Fax: 305-655-0499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME46992
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: