Provider Demographics
NPI:1205072766
Name:LEVY, SHELDON MARK (PHD, MPH)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:MARK
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW 9TH AVE
Mailing Address - Street 2:SUITE 470
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1101
Mailing Address - Country:US
Mailing Address - Phone:305-243-2848
Mailing Address - Fax:305-243-1251
Practice Address - Street 1:1801 NW 9TH AVE
Practice Address - Street 2:SUITE 470
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1101
Practice Address - Country:US
Practice Address - Phone:305-243-2848
Practice Address - Fax:305-243-1251
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7742103TC0700X, 103TC2200X
RIPS00345103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent