Provider Demographics
NPI:1417957903
Name:LEIBENSPERGER, NATALIE SUMNER (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:SUMNER
Last Name:LEIBENSPERGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11175 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5615
Mailing Address - Country:US
Mailing Address - Phone:352-686-8884
Mailing Address - Fax:352-684-6888
Practice Address - Street 1:11175 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5615
Practice Address - Country:US
Practice Address - Phone:352-686-8884
Practice Address - Fax:352-684-6888
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8826207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL81293OtherBCBS
FL267954000Medicaid
FL267954000Medicaid
FL81293ZMedicare ID - Type UnspecifiedM/C PPIN
FLK4876Medicare ID - Type UnspecifiedM/C ID