Provider Demographics
NPI:1821073933
Name:LEVY, JEAN-PIERRE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JEAN-PIERRE
Middle Name:R
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2100 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3772
Mailing Address - Country:US
Mailing Address - Phone:954-454-5455
Mailing Address - Fax:954-454-1587
Practice Address - Street 1:2100 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3772
Practice Address - Country:US
Practice Address - Phone:954-454-5455
Practice Address - Fax:954-454-1587
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40119207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD78952Medicare UPIN
FL95996Medicare PIN