Provider Demographics
NPI:1588604565
Name:LETSKY, JEANNE K (MD)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:K
Last Name:LETSKY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:900 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3920
Mailing Address - Country:US
Mailing Address - Phone:561-733-4400
Mailing Address - Fax:561-733-5004
Practice Address - Street 1:10301 HAGEN RANCH RD STE 760
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3777
Practice Address - Country:US
Practice Address - Phone:561-733-4400
Practice Address - Fax:561-733-5004
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2019-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME105574208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002462100Medicaid