Healthcare Provider Details

I. General information

NPI: 1659511160
Provider Name (Legal Business Name): ERIK LEVY PSYD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 MONIKA CIR
ORLANDO FL
32812-7305
US

IV. Provider business mailing address

3323 MONIKA CIR
ORLANDO FL
32812-7305
US

V. Phone/Fax

Practice location:
  • Phone: 407-408-5906
  • Fax:
Mailing address:
  • Phone: 407-408-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPY 5702
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberPY 5702
License Number StateFL

VIII. Authorized Official

Name: DR. ERIK A LEVY
Title or Position: OWNER
Credential: PSY.D.
Phone: 407-408-5906