Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN12013 | FL |
NPI | 1023031689 |
---|---|
Provider Name | Dr. Hal Jeffrey Levine |
First Address | Kissimmee, FL 34741-4420 |
Second Address | Kissimmee, FL 34741-4420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 12/11/2013 |