Healthcare Provider Details

I. General information

NPI: 1053491308
Provider Name (Legal Business Name): DEBORAH C. LEIBLE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8090 SORRENTO LN SUITE 3
NAPLES FL
34114-2722
US

IV. Provider business mailing address

8090 SORRENTO LN SUITE 3
NAPLES FL
34114-2722
US

V. Phone/Fax

Practice location:
  • Phone: 239-732-7625
  • Fax:
Mailing address:
  • Phone: 239-732-7625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-995
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX005494-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 10802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: