=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912707209
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOANNA MAE LEVY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2025
-----------------------------------------------------
Last Update Date | 01/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 CORAL HILLS DR
-----------------------------------------------------
City | STUART
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34996
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-284-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 104 N LAKESHORE DR
-----------------------------------------------------
City | HYPOLUXO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33462-6069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-954-2445
-----------------------------------------------------
Fax | 561-954-2445
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN11038222
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------