Provider Demographics
NPI:1164413134
Name:LEVITT, STEPHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:
Last Name:LEVITT
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:THE WOODRUFF INSTITUTE
Mailing Address - Street 2:2235 VENETIAN COURT, SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109
Mailing Address - Country:US
Mailing Address - Phone:239-498-3376
Mailing Address - Fax:239-596-9466
Practice Address - Street 1:THE WOODRUFF INSTITUTE
Practice Address - Street 2:2235 VENETIAN COURT, SUITE 1
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109
Practice Address - Country:US
Practice Address - Phone:239-498-3376
Practice Address - Fax:239-596-9466
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 92768207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHD03377Medicare UPIN