Provider Demographics
NPI:1215926043
Name:LEVINSON, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:LEVINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:STE 104
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1007
Mailing Address - Country:US
Mailing Address - Phone:954-435-5828
Mailing Address - Fax:954-435-8451
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:STE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1007
Practice Address - Country:US
Practice Address - Phone:954-435-5828
Practice Address - Fax:954-435-8451
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME15223207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
93253ZMedicare ID - Type Unspecified
D60393Medicare UPIN