Basic Information
| Provider Information | |||||||||
| NPI: | 1437235157 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEVINE | ||||||||
| FirstName: | MYRON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1580 SANTA BARBARA BLVD STE 101 | ||||||||
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| City: | THE VILLAGES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321596827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522592159 | ||||||||
| FaxNumber: | 3522595731 | ||||||||
| Practice Location | |||||||||
| Address1: | 425 E 1ST ST | ||||||||
| Address2: | SUITE101 | ||||||||
| City: | BLOOMSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178151480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703872474 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2006 | ||||||||
| LastUpdateDate: | 04/08/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD009712E | PA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | ME131170 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.