MEDICARE: JULIANNE LEBO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	50.008303RX	OH

General Provider Information

NPI Number	:	1861176687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE LEBO PA

Provider Business Mailing Address
First Line	:	10139 ROYALTON RD STE H
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4473
Country	:	US
Telephone Number	:	440-816-2878
Fax Number	:	440-582-2538

Provider Business Practice Location Address
First Line	:	10139 ROYALTON RD STE H
Second Line	:
City	:	NORTH ROYALTON
State	:	OH
Zip	:	44133-4473
Country	:	US
Telephone Number	:	440-816-2878
Fax Number	:	440-582-2538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	02/12/2026

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