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General NPI Number Information
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NPI Number | 1063478196
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Entity Type | Individual
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Provider Name | BRUCE J LEVINE DPM
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 2521 COUNTRYSIDE BLVD
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City | CLEARWATER
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State | FL
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Zip | 33763-1605
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Country | US
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Telephone | 727-797-5008
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Fax | 797-791-1330
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Provider Business Mailing Address
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Address Line | 2521 COUNTRYSIDE BLVD
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City | CLEARWATER
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State | FL
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Zip | 33763-1605
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Country | US
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Telephone | 727-797-5008
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Fax | 797-791-1330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO1802
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License Number State | FL
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