Provider Demographics
NPI:1356146179
Name:PHILLS, LEVENIA
Entity type:Individual
Prefix:MRS
First Name:LEVENIA
Middle Name:
Last Name:PHILLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19346 MARDI GRAS ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32833-3011
Mailing Address - Country:US
Mailing Address - Phone:347-778-8577
Mailing Address - Fax:
Practice Address - Street 1:19346 MARDI GRAS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32833-3011
Practice Address - Country:US
Practice Address - Phone:347-778-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company