Provider Demographics
NPI:1992091631
Name:LEVAUGH, MICHAEL PAUL (ARNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PAUL
Last Name:LEVAUGH
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4944 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1413
Mailing Address - Country:US
Mailing Address - Phone:850-994-0431
Mailing Address - Fax:850-994-0904
Practice Address - Street 1:4944 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1413
Practice Address - Country:US
Practice Address - Phone:850-994-0431
Practice Address - Fax:850-994-0904
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9232865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily