Healthcare Provider Details

I. General information

NPI: 1427092915
Provider Name (Legal Business Name): ROBERT L LEVINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 SW 66TH ST
SOUTH MIAMI FL
33143-2807
US

IV. Provider business mailing address

11200 SW 8TH ST # 4261
MIAMI FL
33199-2516
US

V. Phone/Fax

Practice location:
  • Phone: 713-248-9977
  • Fax:
Mailing address:
  • Phone: 305-348-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME112820
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberH3101
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME112820
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: