Provider Demographics
NPI:1114937067
Name:LEVIN, RICHARD DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:LEVIN
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 1:21355 E DIXIE HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1238
Mailing Address - Country:US
Mailing Address - Phone:305-932-4444
Mailing Address - Fax:
Practice Address - Street 1:21355 E DIXIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1238
Practice Address - Country:US
Practice Address - Phone:305-932-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71204208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G32376Medicare UPIN
G32376Medicare UPIN