Provider Demographics
NPI:1679879456
Name:LEVIN, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LEVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 N OCEAN BLVD
Mailing Address - Street 2:APT. 3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8304
Mailing Address - Country:US
Mailing Address - Phone:561-866-8275
Mailing Address - Fax:561-391-7169
Practice Address - Street 1:2070 N. OCEAN BLVD
Practice Address - Street 2:APT. 3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-866-8275
Practice Address - Fax:561-391-7169
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist