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General NPI Number Information
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NPI Number | 1154564680
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Entity Type | Organization
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Legal Business Name | GEORGE G LE-BERT DO PA
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 1820 S TREASURE DR APT 303
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City | NORTH BAY VILLAGE
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State | FL
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Zip | 33141-4385
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Country | US
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Telephone | 305-866-3361
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Fax | 866-691-8514
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Provider Business Mailing Address
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Address Line | 1820 S TREASURE DR APT 303
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City | NORTH BAY VILLAGE
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State | FL
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Zip | 33141-4385
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Country | US
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Telephone | 305-866-3361
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Fax | 866-691-8514
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE G LE-BERT
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Credential | DO
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Telephone | 305-866-3361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS10063
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License Number State | FL
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