Provider Demographics
NPI:1851388201
Name:LEVY, JAY HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:HARRIS
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46992207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063692402Medicaid
FLE48525Medicare UPIN
FL063692402Medicaid