Provider Demographics
NPI:1669553632
Name:LEVY, JENNIFER ELLEN (PA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELLEN
Last Name:LEVY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1720 SW CRANE CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2214
Mailing Address - Country:US
Mailing Address - Phone:954-647-6660
Mailing Address - Fax:
Practice Address - Street 1:775 W INDIANTOWN RD STE 5
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7563
Practice Address - Country:US
Practice Address - Phone:561-250-6169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103880363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical