Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME0052225 | FL |
NPI | 1023118379 |
---|---|
Provider Name | Jeffrey Herschel Levenson |
First Address | Jacksonville, FL 32204-3361 |
Second Address | Jacksonville, FL 32204-3361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 11/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07299W | MEDICARE ID (01) | FL |
261362000 | (05) | FL |
D51896 | (02) | FL |