Provider Demographics
NPI:1548337488
Name:LEVIN, SHELDON RAPHAEL (MD)
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:RAPHAEL
Last Name:LEVIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 N FLAMINGO ROAD
Mailing Address - Street 2:315
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028
Mailing Address - Country:US
Mailing Address - Phone:954-436-2100
Mailing Address - Fax:954-433-9919
Practice Address - Street 1:601 N FLAMINGO ROAD
Practice Address - Street 2:315
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-436-2100
Practice Address - Fax:954-433-9919
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-04-14
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Provider Licenses
StateLicense IDTaxonomies
FL062855207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057417100Medicaid
D60417Medicare UPIN
FL057417100Medicaid