Provider Demographics
NPI:1275173718
Name:LEAP PEDIATRICS LLC
Entity Type:Organization
Organization Name:LEAP PEDIATRICS LLC
Other - Org Name:LEAP CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-569-5327
Mailing Address - Street 1:2439 MANHATTAN BLVD STE 501A
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5328
Mailing Address - Country:US
Mailing Address - Phone:504-569-5327
Mailing Address - Fax:504-323-3153
Practice Address - Street 1:2439 MANHATTAN BLVD STE 501A
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-5328
Practice Address - Country:US
Practice Address - Phone:504-569-5327
Practice Address - Fax:504-323-3153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty