1588784490 NPI number — M J LEVITATS MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588784490 NPI number — M J LEVITATS MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M J LEVITATS 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:
Provider Other Organization Name Type Code:
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:
1588784490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3170 N FEDERAL HWY
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
LIGHTHOUSE POINT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33064-6700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-785-0900
Provider Business Mailing Address Fax Number:
954-786-3497

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3170 N FEDERAL HWY
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
LIGHTHOUSE POINT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33064-6700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-785-0900
Provider Business Practice Location Address Fax Number:
954-786-3497
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LEVITATS
Authorized Official First Name:
MERON
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
954-785-0900

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0487411400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com