Leventhal, Jerry

Leventhal, Jerry is an individual health care provider with primary practice located at 21 Hospital Drive Ste 280, Palm Coast FL 32164. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Leventhal, Jerry can be contacted via phone (386) 437-4711.

Contact Information

Primary practice address
21 Hospital Drive Ste 280 Palm Coast FL 32164
Phone: (386) 437-4711
Fax: (386) 437-4772
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME69470 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME69470 Florida

Profile Details

NPI number 1558364265
LBN Legal business name Leventhal, Jerry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Apr 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558364265 NPPES
Florida MEDICAID 277845900
Florida Other 28165

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