Healthcare Provider Details

I. General information

NPI: 1710497375
Provider Name (Legal Business Name): MR. ANDREW BRIAN LEBOVIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 CENTRAL PARK BLVD N STE 126
BOCA RATON FL
33428-1703
US

IV. Provider business mailing address

1397 MEDICAL PARK BLVD STE 220
WELLINGTON FL
33414-3187
US

V. Phone/Fax

Practice location:
  • Phone: 561-369-7137
  • Fax:
Mailing address:
  • Phone: 561-784-0202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9408970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: