Provider Demographics
NPI:1033265053
Name:LEIBOWITZ, LESLIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:LEIBOWITZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 ISLAND BLVD
Mailing Address - Street 2:# 2202
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3762
Mailing Address - Country:US
Mailing Address - Phone:305-931-8900
Mailing Address - Fax:954-583-7388
Practice Address - Street 1:6000 ISLAND BLVD
Practice Address - Street 2:# 2202
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-3762
Practice Address - Country:US
Practice Address - Phone:305-931-8900
Practice Address - Fax:954-583-7388
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist