Provider Demographics
NPI:1710250782
Name:LEVINSON, MELVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:
Last Name:LEVINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MELVIN
Other - Middle Name:
Other - Last Name:LEVINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:60 EDGEWATER DRIVE #7F
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133
Mailing Address - Country:US
Mailing Address - Phone:305-206-2496
Mailing Address - Fax:305-666-7771
Practice Address - Street 1:60 EDGEWATER DR APT 7F
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-6987
Practice Address - Country:US
Practice Address - Phone:305-206-2496
Practice Address - Fax:305-666-7771
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 5300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery