Provider Demographics
NPI:1013008713
Name:LEVERONE, RICHARD A (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:LEVERONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 49TH ST.N.
Mailing Address - Street 2:SUIT F
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710
Mailing Address - Country:US
Mailing Address - Phone:727-579-2500
Mailing Address - Fax:727-579-1060
Practice Address - Street 1:5136 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707
Practice Address - Country:US
Practice Address - Phone:727-579-2500
Practice Address - Fax:727-579-3433
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 17722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89317Medicare ID - Type Unspecified
FLU26577Medicare UPIN