Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 127 | WY |
N | 222Z00000X | Podiatrist | 127 | WY |
N | 213E00000X | Podiatrist | PO3945 | FL |
N | 222Z00000X | Podiatrist | PO3945 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO3945 | FL |
N | 213ES0131X | Foot Surgery | 127 | WY |
NPI | 1326017179 |
---|---|
Provider Name | Dr. Jason Levitre |
First Address | Daytona Beach, FL 32117-7131 |
Second Address | Jacksonville, FL 32224-0235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
022468300 | (05) | FL |
121784400 | (05) | WY |
P00253865 | RAILROAD MEDICARE (01) | WY |
PO3945 | MEDICAL LICENCE (01) | FL |
V06347 | (02) | WY |