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General NPI Number Information
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NPI Number | 1508130634
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Entity Type | Organization
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Legal Business Name | JACOB LEVY, MD PA
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 2344 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3249
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Country | US
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Telephone | 305-649-6090
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Fax | 305-649-4576
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Provider Business Mailing Address
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Address Line | 2344 NW 7TH ST
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City | MIAMI
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State | FL
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Zip | 33125-3249
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Country | US
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Telephone | 305-649-6090
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Fax | 305-649-4576
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACOB LEVY
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Credential | M.D.
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Telephone | 305-649-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | HCC9742
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | HCC9742
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License Number State | FL
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