Provider Demographics
NPI:1861447591
Name:LEVINE, FELICE (MD)
Entity Type:Individual
Prefix:
First Name:FELICE
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7593 W BOYNTON BEACH BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6162
Mailing Address - Country:US
Mailing Address - Phone:561-678-2652
Mailing Address - Fax:888-316-2198
Practice Address - Street 1:1905 CLINT MOORE RD STE 204
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2660
Practice Address - Country:US
Practice Address - Phone:561-544-8938
Practice Address - Fax:561-544-8942
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64413207R00000X
FLME58679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376606300Medicaid
FL25704Medicare PIN