Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY5075 | FL |
Y | 103T00000X | Psychologist | PY5075 | FL |
NPI | 1003039702 |
---|---|
Provider Name | Dr. Frederick C Levy |
First Address | Tallahassee, FL 32308 |
Second Address | Tallahassee, FL 32308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |