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Individual

JANE LEVINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644
Mailing address
602 VONDERBURG DR, SUITE 201, BRANDON, FL 33511-5900
(813) 653-1149
(813) 654-6644

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
2251P0200X
Pediatric Physical Therapist
Primary
1227881
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013226600
FL
05
014372600
FL
Enumeration date
03/06/2013
Last updated
03/05/2015
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