Provider Demographics
NPI:1497719538
Name:LEVASSEUR, JOHN HAZELTON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HAZELTON
Last Name:LEVASSEUR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 VILLAGE SQUARE XING
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4543
Mailing Address - Country:US
Mailing Address - Phone:561-693-0540
Mailing Address - Fax:561-296-6174
Practice Address - Street 1:2601 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4622
Practice Address - Country:US
Practice Address - Phone:772-219-2777
Practice Address - Fax:772-219-0017
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3757363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00416556OtherRAILROAD MEDICARE
FLP00416556OtherRAILROAD MEDICARE
E4491ZMedicare ID - Type Unspecified