Provider Demographics
NPI:1851541924
Name:PUTERBAUGH, LEON FURL
Entity Type:Individual
Prefix:MR
First Name:LEON
Middle Name:FURL
Last Name:PUTERBAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:LEE
Other - Middle Name:FURL
Other - Last Name:PUTERBAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:200 AVENUE F NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4131
Mailing Address - Country:US
Mailing Address - Phone:800-723-3248
Mailing Address - Fax:
Practice Address - Street 1:5825 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1216
Practice Address - Country:US
Practice Address - Phone:863-385-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator