Provider Demographics
NPI:1457359028
Name:LEVIN, ANDREW B (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:B
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33913 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2628
Mailing Address - Country:US
Mailing Address - Phone:727-789-2663
Mailing Address - Fax:727-787-1529
Practice Address - Street 1:33913 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2628
Practice Address - Country:US
Practice Address - Phone:727-789-2663
Practice Address - Fax:727-787-1529
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22894OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FL611618OtherUNITEDHEALTHCARE
FL4316046OtherAETNA
FLU43066Medicare UPIN
FL4316046OtherAETNA