Provider Demographics
NPI:1013031160
Name:KAHANE, LEVI
Entity Type:Individual
Prefix:DR
First Name:LEVI
Middle Name:
Last Name:KAHANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 N 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2332
Mailing Address - Country:US
Mailing Address - Phone:954-485-8888
Mailing Address - Fax:
Practice Address - Street 1:4720 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5860
Practice Address - Country:US
Practice Address - Phone:954-485-8888
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL777262084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256199900Medicaid
FLE2161XMedicare ID - Type Unspecified
FLG95387Medicare UPIN