Provider Demographics
NPI:1265468797
Name:LEVENTHAL, BETH M (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:M
Last Name:LEVENTHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:MINDY
Other - Last Name:FROMKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1150 N 35TH AVE STE 465
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5467
Mailing Address - Country:US
Mailing Address - Phone:549-986-9008
Mailing Address - Fax:954-986-6646
Practice Address - Street 1:1150 N 35TH AVE STE 465
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5467
Practice Address - Country:US
Practice Address - Phone:549-986-9008
Practice Address - Fax:954-986-6646
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0083467207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15656200Medicaid
FLE6466ZMedicare ID - Type Unspecified
FL263387600Medicaid