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General NPI Number Information
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NPI Number | 1942241575
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Entity Type | Individual
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Provider Name | MARC IVEN LEVINE MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 111 SE OSCEOLA ST STE 100
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City | STUART
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State | FL
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Zip | 34994-2114
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Country | US
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Telephone | 772-223-2115
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Fax | 772-223-9238
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Provider Business Mailing Address
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Address Line | 3500 SW CENTER CT
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City | PALM CITY
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State | FL
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Zip | 34990-2312
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Country | US
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Telephone | 177-222-2115
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME56758
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME56758
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License Number State | FL
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