Provider Demographics
NPI:1982644126
Name:JOCELYN E. LEVEQUE, MD PL
Entity Type:Organization
Organization Name:JOCELYN E. LEVEQUE, MD PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEVEQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-934-8893
Mailing Address - Street 1:350 PENSACOLA BEACH BLVD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4882
Mailing Address - Country:US
Mailing Address - Phone:850-934-8893
Mailing Address - Fax:850-934-8858
Practice Address - Street 1:350 PENSACOLA BEACH BLVD.
Practice Address - Street 2:SUITE B
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4882
Practice Address - Country:US
Practice Address - Phone:850-934-8893
Practice Address - Fax:850-934-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00796332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL97105OtherBC/BS OF FL GROUP #
FLK6935Medicare ID - Type UnspecifiedMEDICARE GROUP #
FL97105OtherBC/BS OF FL GROUP #