Provider Demographics
NPI:1073836201
Name:DAVID J. LEVENS, M.D., P.A.
Entity Type:Organization
Organization Name:DAVID J. LEVENS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-752-1020
Mailing Address - Street 1:1725 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6089
Mailing Address - Country:US
Mailing Address - Phone:954-752-1020
Mailing Address - Fax:954-752-0717
Practice Address - Street 1:1725 N UNIVERSITY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6089
Practice Address - Country:US
Practice Address - Phone:954-752-1020
Practice Address - Fax:954-752-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00562752086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL038416000Medicaid
FL038416000Medicaid