Healthcare Provider Details

I. General information

NPI: 1235068990
Provider Name (Legal Business Name): ROBERT JOSEPH LEBOEUF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 S PORTAGE PATH
AKRON OH
44320-2326
US

IV. Provider business mailing address

380 S PORTAGE PATH
AKRON OH
44320-2326
US

V. Phone/Fax

Practice location:
  • Phone: 330-315-3703
  • Fax: 330-293-2172
Mailing address:
  • Phone: 330-315-3703
  • Fax: 330-293-2172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: