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General NPI Number Information
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NPI Number | 1205824794
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Entity Type | Organization
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Legal Business Name | JON I LEVIN DO PA
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 938 N MILLS AVE
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City | ARCADIA
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State | FL
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Zip | 34266-8780
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Country | US
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Telephone | 863-494-6694
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Fax | 863-494-0406
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Provider Business Mailing Address
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Address Line | 938 N MILLS AVE
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City | ARCADIA
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State | FL
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Zip | 34266-8780
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Country | US
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Telephone | 863-494-6694
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Fax | 863-494-0406
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Authorized Official
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Title or Position | OWNER
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Name | JON I LEVIN
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Credential | DO
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Telephone | 863-494-6694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 057941
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 057941
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License Number State | FL
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