MEDICARE: KATHLEEN LEBER, MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1336105758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHLEEN LEBER, MD PA

Provider Business Mailing Address
First Line	:	2835 W DE LEON ST
Second Line	:	SUITE 201
City	:	TAMPA
State	:	FL
Zip	:	33609-4168
Country	:	US
Telephone Number	:	813-350-0700
Fax Number	:	813-350-0703

Provider Business Practice Location Address
First Line	:	2835 W DE LEON ST
Second Line	:	SUITE 201
City	:	TAMPA
State	:	FL
Zip	:	33609-4168
Country	:	US
Telephone Number	:	813-350-0700
Fax Number	:	813-350-0703

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATHLEEN LEBER
Credential	:	M.D.
Telephone Number	:	813-350-0700

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	07/28/2016

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