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General NPI Number Information
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NPI Number | 1124670203
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Entity Type | Individual
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Provider Name | PATRICK LEBER PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 6 ARAGON AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-5300
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Country | US
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Telephone | 305-448-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 26160 SW 122ND CT
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City | HOMESTEAD
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State | FL
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Zip | 33032-7003
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Country | US
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Telephone | 754-581-0230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 9111703
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License Number State | FL
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