Provider Demographics
NPI:1689895229
Name:LEVINE, PAULA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:A
Last Name:LEVINE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MAJORCA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4508
Mailing Address - Country:US
Mailing Address - Phone:305-448-8325
Mailing Address - Fax:305-448-0687
Practice Address - Street 1:111 MAJORCA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4508
Practice Address - Country:US
Practice Address - Phone:305-448-8325
Practice Address - Fax:305-448-0687
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 2929103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75270Medicare ID - Type UnspecifiedMEDICARE NUMBER