MEDICARE: PEDIATRICS

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	174400000X	Specialist	ME88260	FL

General Provider Information

NPI Number	:	1366840837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRICS

Provider Business Mailing Address
First Line	:	13130 ALHAMBRA LAKE CIR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-3734
Country	:	US
Telephone Number	:	561-495-4005
Fax Number	:

Provider Business Practice Location Address
First Line	:	13130 ALHAMBRA LAKE CIR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-3734
Country	:	US
Telephone Number	:	561-495-4005
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. STEPHEN D LEVINE
Credential	:	MD
Telephone Number	:	561-495-4005

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	12/15/2014

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Directions to “PEDIATRICS ” Practice Location

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