Healthcare Provider Details

I. General information

NPI: 1942541735
Provider Name (Legal Business Name): HEALTHYFITT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2013
Last Update Date: 03/05/2013
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 TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 10802
License Number StateFL

VIII. Authorized Official

Name: DR. DEBORAH C LEIBLE
Title or Position: OWNER
Credential: D.C.
Phone: 239-732-7625