Provider Demographics
NPI:1770811689
Name:JR LEVY, INC.
Entity type:Organization
Organization Name:JR LEVY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:954-529-7300
Mailing Address - Street 1:10973 NW 64TH DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3738
Mailing Address - Country:US
Mailing Address - Phone:954-529-7300
Mailing Address - Fax:754-529-8998
Practice Address - Street 1:10973 NW 64TH DR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-3738
Practice Address - Country:US
Practice Address - Phone:954-529-7300
Practice Address - Fax:754-529-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty