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Individual
LARRY R. LEVINE
Active
Individual
LARRY R. LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS0006010
FL
208D00000X
General Practice Physician
Primary
OS6010
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044135000
—
FL
01
—
21762
BCBS
FL
01
—
82873K
MEDICARE
FL
01
—
E32308
MEDICARE UPIN
FL
Enumeration date
06/10/2005
Last updated
01/22/2019
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