Provider Demographics
NPI:1184616351
Name:LEVITT, ALISON D (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:D
Last Name:LEVITT
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 1:20665 LYONS RD
Mailing Address - Street 2:A3
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3911
Mailing Address - Country:US
Mailing Address - Phone:561-883-6677
Mailing Address - Fax:561-883-6677
Practice Address - Street 1:20665 LYONS RD
Practice Address - Street 2:A3
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3911
Practice Address - Country:US
Practice Address - Phone:561-883-6677
Practice Address - Fax:561-883-6677
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46379207Q00000X
FLME115978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN064922800Medicaid
080013139Medicare ID - Type Unspecified
H28970Medicare UPIN