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General NPI Number Information
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NPI Number | 1851260152
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Entity Type | Organization
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Legal Business Name | ELYSIAN MIND & BODY PLLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1702 S DIXIE HWY
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City | LAKE WORTH BEACH
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State | FL
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Zip | 33460-5886
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Country | US
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Telephone | 959-216-6130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 450051
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City | SUNRISE
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State | FL
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Zip | 33345-0051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | IREON LEBEAUF
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Credential | MD
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Telephone | 504-430-9322
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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 |
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License Number State |
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