Healthcare Provider Details

I. General information

NPI: 1245209717
Provider Name (Legal Business Name): ELENA F FEBRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 SUN N LAKE BLVD
SEBRING FL
33872
US

IV. Provider business mailing address

PO BOX 864442
ORLANDO FL
32886-0001
US

V. Phone/Fax

Practice location:
  • Phone: 863-314-4466
  • Fax: 863-402-3463
Mailing address:
  • Phone: 305-503-6320
  • Fax: 305-503-5617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number77489
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: