MEDICARE: DR. DAVID ALAN LEVINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ME51828	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07794	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114914249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALAN LEVINE MD

Provider Business Mailing Address
First Line	:	4957 38TH AVE N
Second Line	:	STE B
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-2174
Country	:	US
Telephone Number	:	727-522-8878
Fax Number	:	727-521-1192

Provider Business Practice Location Address
First Line	:	4957 38TH AVE N
Second Line	:	STE B
City	:	ST PETERSBURG
State	:	FL
Zip	:	33710-2174
Country	:	US
Telephone Number	:	727-522-8878
Fax Number	:	727-521-1192

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	02/04/2010

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