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General NPI Number Information
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NPI Number | 1720256126
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Entity Type | Organization
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Legal Business Name | MONSOUR WEAVER LEB PA
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 1680 DUNLAWTON AVE
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City | PORT ORANGE
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State | FL
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Zip | 32127-4754
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Country | US
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Telephone | 386-304-1212
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Fax | 386-304-8244
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Provider Business Mailing Address
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Address Line | 26 EMERALD CIR
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City | ORMOND BEACH
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State | FL
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Zip | 32174-4005
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Country | US
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Telephone | 386-304-1212
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Fax | 386-304-8244
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | DR. ROBERT B. LEB
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Credential | M.D.
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Telephone | 386-304-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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