Provider Demographics
NPI:1013980952
Name:LEVY, JONATHAN CHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHAD
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 CENTRAL PARK BLVD N STE 150A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1760
Mailing Address - Country:US
Mailing Address - Phone:561-922-9112
Mailing Address - Fax:
Practice Address - Street 1:9960 CENTRAL PARK BLVD N STE 150A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1760
Practice Address - Country:US
Practice Address - Phone:561-922-9112
Practice Address - Fax:561-367-5399
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93009207X00000X
FLME 93009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272600900Medicaid
FLU5170ZMedicare ID - Type Unspecified
FL272600900Medicaid