MEDICARE: DR. STEPHEN RONALD LEVIN PH.D.

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	103T00000X	Psychologist	PY5941	FL

General Provider Information

NPI Number	:	1578593661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN RONALD LEVIN PH.D.

Provider Business Mailing Address
First Line	:	5100 N OCEAN BLVD
Second Line	:	#1013
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-3036
Country	:	US
Telephone Number	:	954-709-7843
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 N OCEAN BLVD
Second Line	:	#1013
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-3036
Country	:	US
Telephone Number	:	954-709-7843
Fax Number	:

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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