Provider Demographics
NPI:1114057585
Name:STEPHEN F LEVIN DPM PA
Entity Type:Organization
Organization Name:STEPHEN F LEVIN DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FARBER
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:813-973-3535
Mailing Address - Street 1:26827 FOGGY CREEK RD
Mailing Address - Street 2:STE 104
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6768
Mailing Address - Country:US
Mailing Address - Phone:813-973-3535
Mailing Address - Fax:813-907-2963
Practice Address - Street 1:26827 FOGGY CREEK RD
Practice Address - Street 2:STE 104
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6768
Practice Address - Country:US
Practice Address - Phone:813-973-3535
Practice Address - Fax:813-907-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2726213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009078400Medicaid
FLDB5693OtherRAILROAD MEDICARE
FL003CSOtherBLUE CROSS BLUE SHIELD FL
FL390427001Medicaid
FL390427000Medicaid
FL003CSOtherBLUE CROSS BLUE SHIELD FL
FLU71357Medicare UPIN
FL390427000Medicaid
FL4989030001Medicare NSC