Provider Demographics
NPI:1699822619
Name:J HARRIS LEVY MD PA
Entity Type:Organization
Organization Name:J HARRIS LEVY MD PA
Other - Org Name:RETINA ASSOCIATES OF MIAMI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-655-0411
Mailing Address - Street 1:184 NE 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3412
Mailing Address - Country:US
Mailing Address - Phone:305-655-0411
Mailing Address - Fax:305-655-0499
Practice Address - Street 1:184 NE 168TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3412
Practice Address - Country:US
Practice Address - Phone:305-655-0411
Practice Address - Fax:305-655-0499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46992207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1175Medicare ID - Type UnspecifiedGROUP ID