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NPI Code Detail

MEDICARE: RICHARD M. LEVINE, DDS, PA

MEDICARE: RICHARD M. LEVINE, DDS, PA
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
11223P0300XPeriodontics5871FL

General Provider Information

NPI Number : 1760507008
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD M. LEVINE, DDS, PA
Provider Business Mailing Address
First Line : 1311 W BUSCH BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-7709
Country : US
Telephone Number : 813-935-3585
Fax Number : 813-930-9211
Provider Business Practice Location Address
First Line : 1311 W BUSCH BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-7709
Country : US
Telephone Number : 813-935-3585
Fax Number : 813-930-9211
Authorized Official
Title or Position : PRESIDENT
Name : DR. RICHARD M. LEVINE
Credential : DDS
Telephone Number : 813-935-3585
Provider Enumeration Date : 03/19/2007
Last Update Date : 08/22/2020

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