Individual
GLENN ALAN LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT
Contact information
Practice address
1427 GOLDEN WILLOW CT, FLEMING ISLAND, FL 32003-3210
(904) 228-1259
Mailing address
1427 GOLDEN WILLOW CT, FLEMING ISLAND, FL 32003-3210
(904) 228-1259
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
TT4696
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TT4696
FLORIDA DEPT. OF HEALTH
FL
Enumeration date
03/24/2015
Last updated
04/30/2015
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