Provider Demographics
NPI:1851560312
Name:LEVINE, JASON EVAN (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:EVAN
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1201 N. 35TH AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5468
Mailing Address - Country:US
Mailing Address - Phone:954-987-8100
Mailing Address - Fax:954-989-0160
Practice Address - Street 1:1201 N. 35TH AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5468
Practice Address - Country:US
Practice Address - Phone:954-987-8100
Practice Address - Fax:954-989-0160
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2020-10-07
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Provider Licenses
StateLicense IDTaxonomies
FLME108919208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery