Provider Demographics
NPI:1356515183
Name:LEVY, BRUCE F
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:F
Last Name:LEVY
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:BRUCE
Other - Middle Name:F
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:17038 W DIXIE HWY
Mailing Address - Street 2:151
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3723
Mailing Address - Country:US
Mailing Address - Phone:305-653-2585
Mailing Address - Fax:305-468-3941
Practice Address - Street 1:17038 W DIXIE HWY
Practice Address - Street 2:151
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3723
Practice Address - Country:US
Practice Address - Phone:305-653-2585
Practice Address - Fax:305-468-3941
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor