Provider Demographics
NPI:1255917266
Name:LEBRUN, PIERRELA
Entity type:Individual
Prefix:
First Name:PIERRELA
Middle Name:
Last Name:LEBRUN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8391 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7307
Mailing Address - Country:US
Mailing Address - Phone:543-356-9259
Mailing Address - Fax:954-400-3550
Practice Address - Street 1:8391 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7307
Practice Address - Country:US
Practice Address - Phone:954-335-6925
Practice Address - Fax:954-400-3550
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-20
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012028363LF0000X
FLAPRN11012028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty