MEDICARE: DR. DANIEL JOHN LEBOWITZ M.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	202K00000X	Phlebology Physician	ME162079	FL
2	2085R0202X	Diagnostic Radiology Physician	MD430274	PA
3	2085R0202X	Diagnostic Radiology Physician	214170	NY
4	2085R0202X	Diagnostic Radiology Physician	25MA08301000	NJ
5	2085R0204X	Vascular & Interventional Radiology Physician	ME162079	FL

General Provider Information

NPI Number	:	1962409953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL JOHN LEBOWITZ M.D.

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1893
Country	:	US
Telephone Number	:	813-867-0606
Fax Number	:	813-434-2023

Provider Business Practice Location Address
First Line	:	1900 GLADES RD STE 100
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7333
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:	888-812-8191

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/15/2025

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