Provider Demographics
NPI:1417492984
Name:LEVIN, MERA (OTRL)
Entity Type:Individual
Prefix:
First Name:MERA
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 COLLINS AVE
Mailing Address - Street 2:APT 507
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2680
Mailing Address - Country:US
Mailing Address - Phone:773-870-0901
Mailing Address - Fax:
Practice Address - Street 1:9511 COLLINS AVE
Practice Address - Street 2:APT 507
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-2680
Practice Address - Country:US
Practice Address - Phone:773-870-0901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist