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General NPI Number Information
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NPI Number | 1588907273
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Entity Type | Individual
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Provider Name | GARRICK LEONARD KLAYBOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 11215 METRO PKWY STE 100
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City | FORT MYERS
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State | FL
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Zip | 33966-1206
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Country | US
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Telephone | 239-387-2695
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Fax |
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Provider Business Mailing Address
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Address Line | 620 N SALCEDO ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-4022
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Country | US
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Telephone | 504-250-8167
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 300699
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME165848
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License Number State | FL
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