1437549243 NPI number — ELI S. LEVINE, MD, PA

Table of content: (NPI 1437549243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437549243 NPI number — ELI S. LEVINE, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELI S. LEVINE, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ADVANCED HEART & VASCULAR INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437549243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
951 NW 13TH ST
Provider Second Line Business Mailing Address:
SUITE 4B
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33486-2359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-235-5621
Provider Business Mailing Address Fax Number:
561-235-5495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
951 NW 13TH ST
Provider Second Line Business Practice Location Address:
SUITE 4B
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33486-2359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-235-5621
Provider Business Practice Location Address Fax Number:
561-235-5495
Provider Enumeration Date:
02/01/2015

Additional Information

Authorized Official

Authorized Official Last Name:
LEVINE
Authorized Official First Name:
ELI
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-235-5621

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME121908 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: ME121908 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: ME121908 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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