Provider Demographics
NPI:1366445744
Name:LEVITT, CLIFFORD ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:ALFRED
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 1:4902 EISENHOWER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6344
Mailing Address - Country:US
Mailing Address - Phone:813-636-2000
Mailing Address - Fax:813-286-8835
Practice Address - Street 1:4321 N MACDILL AVE
Practice Address - Street 2:STE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6390
Practice Address - Country:US
Practice Address - Phone:813-874-1594
Practice Address - Fax:813-874-1062
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16148207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057678600Medicaid
FLE11997Medicare UPIN
FL057678600Medicaid