Provider Demographics
NPI:1386608016
Name:LEVI, ALLAN D (MD, PHD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:D
Last Name:LEVI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 NW 14TH TERRACE
Mailing Address - Street 2:LOIS POPE LIFE CENTER
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-243-6946
Mailing Address - Fax:305-243-3337
Practice Address - Street 1:1095 NW 14TH TERRACE
Practice Address - Street 2:LOIS POPE LIFE CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-6946
Practice Address - Fax:305-243-3337
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65480207T00000X
FLME000654480207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251334000Medicaid
FL2513340-00Medicaid
FLG39350Medicare UPIN
FL2513340-00Medicaid