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General NPI Number Information
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NPI Number | 1528007671
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Entity Type | Individual
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Provider Name | CHERRYLL A. LEBLANC MD
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1613 HARRISON PKWY #200
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City | SUNRISE
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State | FL
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Zip | 33323-2853
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Country | US
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Telephone | 954-838-2371
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Fax | 954-851-1758
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Provider Business Mailing Address
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Address Line | 4655 CHADWICK DRIVE
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City | BEAUMONT
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State | TX
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Zip | 77706
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Country | US
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Telephone | 409-347-4400
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 013378
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K6085
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License Number State | TX
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