Provider Demographics
NPI:1083145924
Name:LEVITSKY, MATTHEW MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MICHAEL
Last Name:LEVITSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1350 TAMIAMI TRL N STE 203
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5209
Mailing Address - Country:US
Mailing Address - Phone:239-325-1131
Mailing Address - Fax:239-262-5980
Practice Address - Street 1:1350 TAMIAMI TRL N STE 203
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5209
Practice Address - Country:US
Practice Address - Phone:239-325-1131
Practice Address - Fax:239-262-5980
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-01092207X00000X
FLME163907207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery