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Individual

DR. MICHAEL S LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
801 E DIXIE AVE, SUITE 104, LEESBURG, FL 34748-7601
(352) 365-2583
(352) 728-6749
Mailing address
734 N 3RD ST, SUITE115, LEESBURG, FL 34748-5285
(352) 365-2583
(352) 728-6749

Taxonomy

Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
25408
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME25408
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
068346900
FL
01
300092999
RR MEDICARE LMIV
FL
01
300114872
RR MEDICARE RACF
FL
Enumeration date
04/24/2006
Last updated
02/24/2016
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