Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME0032459 | FL |
NPI | 1225189137 |
---|---|
Provider Name | Ronald Douglas Levy |
First Address | Melbourne, FL 32902-1000 |
Second Address | Melbourne, FL 32901-3278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D51301 | (02) | FL |