Provider Demographics
NPI:1003910316
Name:LEVY, ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:LEVY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19906 NE 36TH PL
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3072
Mailing Address - Country:US
Mailing Address - Phone:305-682-9628
Mailing Address - Fax:
Practice Address - Street 1:1515 E. HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:954-454-0243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0017285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist