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Organization

FORT LAUDERDALE SURGICAL SPECIALISTS P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN SCOTT LEVINE MD (OWNER/ PRESIDENT)
(954) 202-0242
Entity
Organization

Contact information

Practice address
4801 N FEDERAL HWY, SUITE 101, FORT LAUDERDALE, FL 33308-4618
(954) 202-0242
(954) 202-0243
Mailing address
4801 N FEDERAL HWY, SUITE 101, FORT LAUDERDALE, FL 33308-4618
(954) 202-0242
(954) 202-0243

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME42654
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
374861800
FL
Enumeration date
09/29/2006
Last updated
09/18/2007
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