Healthcare Provider Details

I. General information

NPI: 1427113570
Provider Name (Legal Business Name): ALAN MARK LEVINE MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 PASADENA AVE S
SOUTH PASADENA FL
33707-3717
US

IV. Provider business mailing address

PO BOX 4965
CLEARWATER FL
33758-4965
US

V. Phone/Fax

Practice location:
  • Phone: 727-938-8806
  • Fax: 727-934-6370
Mailing address:
  • Phone: 727-298-2334
  • Fax: 727-298-2335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME60028
License Number StateFL

VIII. Authorized Official

Name: ALAN MARK LEVINE
Title or Position: PRESIDENT
Credential: MD
Phone: 727-298-2334