Provider Demographics
NPI:1881674927
Name:LEBOW, DAFNA (MD)
Entity Type:Individual
Prefix:
First Name:DAFNA
Middle Name:
Last Name:LEBOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 NW 70TH AVE
Mailing Address - Street 2:SUITE120
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2385
Mailing Address - Country:US
Mailing Address - Phone:954-791-2810
Mailing Address - Fax:954-791-9810
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:SUITE120
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2385
Practice Address - Country:US
Practice Address - Phone:954-791-2810
Practice Address - Fax:954-791-9810
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52925207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05629ZMedicare ID - Type Unspecified
D51374Medicare UPIN