Provider Demographics
NPI:1851970859
Name:LEVINE, SARA ROSE (DC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ROSE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 NW 18TH MNR
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5711
Mailing Address - Country:US
Mailing Address - Phone:954-778-9796
Mailing Address - Fax:
Practice Address - Street 1:801 SE 6TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5185
Practice Address - Country:US
Practice Address - Phone:561-808-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13489111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation