Provider Demographics
NPI:1962457952
Name:LEVENSON RAZ, JANET (PSYD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:LEVENSON RAZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 E SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5009
Mailing Address - Country:US
Mailing Address - Phone:954-309-1126
Mailing Address - Fax:
Practice Address - Street 1:2531 E SARATOGA DR
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33026-5009
Practice Address - Country:US
Practice Address - Phone:954-309-1126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5455103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
59887ZMedicare UPIN
FL59887ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER