Provider Demographics
NPI:1669945747
Name:LEVRIER, MICHELIE
Entity type:Individual
Prefix:
First Name:MICHELIE
Middle Name:
Last Name:LEVRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELIE
Other - Middle Name:
Other - Last Name:ROSARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2013 LIVE OAK BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-8410
Mailing Address - Country:US
Mailing Address - Phone:407-593-2388
Mailing Address - Fax:407-593-2392
Practice Address - Street 1:2013 LIVE OAK BLVD
Practice Address - Street 2:STE C
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-8410
Practice Address - Country:US
Practice Address - Phone:407-593-2388
Practice Address - Fax:407-593-2392
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000869363LP0808X
FLAPRN11000869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty