Provider Demographics
NPI:1578503876
Name:MY GYNECOLOGIST PA
Entity Type:Organization
Organization Name:MY GYNECOLOGIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEIBENSPERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-686-8884
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:352-684-7886
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:352-684-7886
Practice Address - Fax:352-684-6888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty