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General NPI Number Information
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NPI Number | 1497719538
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Entity Type | Individual
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Provider Name | JOHN HAZELTON LEVASSEUR PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 2601 S KANNER HWY
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City | STUART
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State | FL
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Zip | 34994-4622
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Country | US
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Telephone | 772-219-2777
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Fax | 772-219-0017
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Provider Business Mailing Address
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Address Line | 600 VILLAGE SQUARE XING
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4543
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Country | US
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Telephone | 561-693-0540
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Fax | 561-296-6174
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA3757
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License Number State | FL
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