Provider Demographics
NPI:1851560312
Name:LEVINE, JASON EVAN (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:EVAN
Last Name:LEVINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3702 WASHINGTON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8287
Mailing Address - Country:US
Mailing Address - Phone:754-663-5521
Mailing Address - Fax:754-663-5522
Practice Address - Street 1:3702 WASHINGTON ST STE 305
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8287
Practice Address - Country:US
Practice Address - Phone:754-663-5521
Practice Address - Fax:754-663-5522
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1089192086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery