Doctor Name: | DR. LEOPOLD BEJAMIN LEBLIQUE |
NPI Number: | 1790900447 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME 43569 |
Business Practice Address: | 264 Sw Ridgeview Pl. Lake City, FL - 32024 |
Business Phone Number: | 3867523768 |
Business Fax Number: | |
Mailing Address: | Po Box 7051, LAKE CITY |
State: | FL |
Postal Code: | 320550051 |
Phone Number: | 3867523768 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 43569 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |