Provider Demographics
NPI:1912095464
Name:LEVIN, BRUCE S (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:S
Last Name:LEVIN
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 1:4600 LINTON BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6600
Mailing Address - Country:US
Mailing Address - Phone:561-501-6902
Mailing Address - Fax:561-455-2125
Practice Address - Street 1:4600 LINTON BLVD STE 340
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-501-6902
Practice Address - Fax:561-455-2125
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME32837207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5905Medicare ID - Type Unspecified
FL1396863361Medicare NSC
FL1912095464Medicare NSC
FLD58768Medicare UPIN