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General NPI Number Information
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NPI Number | 1487033882
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Entity Type | Individual
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Provider Name | TAMI LEEBERG APRN
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Gender | Female
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1344 S APOLLO BLVD STE 2C
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City | MELBOURNE
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State | FL
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Zip | 32901-3183
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Country | US
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Telephone | 321-429-2677
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Fax | 321-456-5444
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Provider Business Mailing Address
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Address Line | 5835 BRABROOK AVE
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City | GRANT
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State | FL
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Zip | 32949-2130
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Country | US
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Telephone | 812-350-9187
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9435838
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License Number State | FL
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