Provider Demographics
NPI:1134369036
Name:LEVIN, BARRY KENNETH (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:KENNETH
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5002
Mailing Address - Country:US
Mailing Address - Phone:941-312-4166
Mailing Address - Fax:
Practice Address - Street 1:1729 CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5002
Practice Address - Country:US
Practice Address - Phone:215-356-7031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA041306002083X0100X
PAMD072693L2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine