Provider Demographics
NPI:1083702617
Name:LEVY, ORIN M (MD)
Entity Type:Individual
Prefix:
First Name:ORIN
Middle Name:M
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 N UNIVERSITY DR
Mailing Address - Street 2:SUITE #210
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1405
Mailing Address - Country:US
Mailing Address - Phone:954-753-0411
Mailing Address - Fax:954-344-6307
Practice Address - Street 1:2855 N UNIVERSITY DR
Practice Address - Street 2:SUITE #210
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1405
Practice Address - Country:US
Practice Address - Phone:954-753-0411
Practice Address - Fax:954-344-6307
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056278174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE22506Medicare UPIN