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General NPI Number Information
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NPI Number | 1205953098
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Entity Type | Individual
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Provider Name | SUSAN EMILY LEVINES P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2530 RIDGETOP WAY
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City | VALRICO
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State | FL
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Zip | 33594-4223
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Country | US
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Telephone | 813-684-9985
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 HULETT DR
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City | BRANDON
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State | FL
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Zip | 33511-2248
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Country | US
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Telephone | 813-681-4991
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT14743
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License Number State | FL
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