Provider Demographics
NPI:1619570223
Name:LEBLEU, ANDREA E (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:E
Last Name:LEBLEU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ANDREEA
Other - Middle Name:E
Other - Last Name:LEBLEU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10948 CHERRY LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-9155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1209 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3643
Practice Address - Country:US
Practice Address - Phone:239-772-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist