Healthcare Provider Details
I. General information
NPI: 1265468797
Provider Name (Legal Business Name): BETH M. LEVENTHAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/25/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 N FLAMINGO RD STE 265
PEMBROKE PINES FL
33028-1013
US
IV. Provider business mailing address
603 N FLAMINGO RD STE 265
PEMBROKE PINES FL
33028-1013
US
V. Phone/Fax
- Phone: 954-986-9008
- Fax: 954-986-6646
- Phone: 549-986-9008
- Fax: 954-986-6646
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | ME0083467 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: