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NPI Code Detail

MEDICARE: GRACIA LEBRUN M.D.

MEDICARE: GRACIA LEBRUN M.D.
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
1207R00000XInternal Medicine PhysicianME113466FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578584389
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIA LEBRUN M.D.
Provider Business Mailing Address
First Line : 4849 LAKE WORTH RD
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3455
Country : US
Telephone Number : 561-433-4446
Fax Number : 561-433-3026
Provider Business Practice Location Address
First Line : 4849 LAKE WORTH RD
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3455
Country : US
Telephone Number : 561-433-4446
Fax Number : 561-433-3026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 02/12/2014

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Directions to “ GRACIA LEBRUN M.D.” Practice Location

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