Provider Demographics
NPI:1477651255
Name:LEBOW, LEONARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:S
Last Name:LEBOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6757
Mailing Address - Country:US
Mailing Address - Phone:954-748-4433
Mailing Address - Fax:954-748-9411
Practice Address - Street 1:7800 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6757
Practice Address - Country:US
Practice Address - Phone:954-748-4433
Practice Address - Fax:954-748-9411
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00201712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
71981Medicare ID - Type Unspecified
D58266Medicare UPIN