Provider Demographics
NPI:1932183324
Name:LEVITT, ALAN P (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:P
Last Name:LEVITT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 IVES DAIRY RD
Mailing Address - Street 2:#133
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2538
Mailing Address - Country:US
Mailing Address - Phone:305-651-8832
Mailing Address - Fax:305-651-0044
Practice Address - Street 1:1031 IVES DAIRY RD
Practice Address - Street 2:#133
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2538
Practice Address - Country:US
Practice Address - Phone:305-651-8832
Practice Address - Fax:305-651-0044
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0782254 00Medicaid
FL0559550001Medicare NSC
FL19676Medicare PIN
T85216Medicare UPIN