Provider Demographics
NPI:1164508248
Name:LEFAVE, DEBBIE EUGENIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:EUGENIE
Last Name:LEFAVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 TEMPLE TER STE 300
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4869
Mailing Address - Country:US
Mailing Address - Phone:727-398-5295
Mailing Address - Fax:727-391-2742
Practice Address - Street 1:10850 TEMPLE TER STE 300
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4869
Practice Address - Country:US
Practice Address - Phone:727-398-5295
Practice Address - Fax:727-391-2742
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42903207R00000X
GA050204207R00000X
FLME56026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME56026OtherDOH