Provider Demographics
NPI:1922055318
Name:LEVIN, JOHN S (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:LEVIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:180 JFK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6641
Mailing Address - Country:US
Mailing Address - Phone:561-967-6500
Mailing Address - Fax:561-963-5600
Practice Address - Street 1:180 JFK DR STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6641
Practice Address - Country:US
Practice Address - Phone:561-967-6500
Practice Address - Fax:561-963-5600
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA01950213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056309900Medicaid
FL65070YMedicare ID - Type Unspecified
FL056309900Medicaid