# LEVANTE MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801183397
- **Authorized official:** DONNA JEAN O'HARA ARNP-BC (OWNER)
- **Authorized official phone:** (352) 250-2610

## Contact information

- **Practice address:** 112 S MAIN ST, WILDWOOD, FL 34785-4539
- **Practice address phone:** (352) 250-2610
- **Practice address fax:** (352) 326-9266
- **Mailing address:** 1638 LEESBURG BLVD, FRUITLAND PARK, FL 34731-5215
- **Mailing address phone:** (352) 326-4269
- **Mailing address fax:** (352) 326-9266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | ARNP2152202 | FL | Yes |

## Other

- **Enumeration date:** 07/05/2011
- **Last updated:** 08/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000360200 | MEDICAID INDIVIDUAL PROVIDER NUMBER - SEE OTHER \#'S DESIGNATED FOR LLC | FL |
| 01 | — | 1710186267 | NPI INDIVIDUAL RENDERING PROVIDER | FL |
| 01 | — | AL386 | MEDICARE INDIVIDUAL PROVIDER NUMBER - SEE OTHER DESIGNATED \#'S FOR LLC | FL |