Provider Demographics
NPI:1548243496
Name:LEVINE, ADAM S (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:S
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD, JD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1180 GULF BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33767-2752
Mailing Address - Country:US
Mailing Address - Phone:727-512-1969
Mailing Address - Fax:866-242-4946
Practice Address - Street 1:1180 GULF BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33767-2752
Practice Address - Country:US
Practice Address - Phone:727-512-1969
Practice Address - Fax:866-242-4946
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2016-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL76015207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254181500Medicaid
FL43568Medicare PIN
FL254181500Medicaid