Provider Demographics
NPI:1265822712
Name:LEIBOWITZ, BETSY (ARNP)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:LEIBOWITZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5998 LAS COLINAS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6559
Mailing Address - Country:US
Mailing Address - Phone:786-385-8795
Mailing Address - Fax:
Practice Address - Street 1:101 PLAZA REAL S STE A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4855
Practice Address - Country:US
Practice Address - Phone:866-641-2673
Practice Address - Fax:561-300-2118
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9235983207Q00000X
FLARNP9235983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine