Provider Demographics
NPI:1720421522
Name:LEFEBRE, JULIANA (DO)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:LEFEBRE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DAVIS BLVD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 DAVIS BLVD
Practice Address - Street 2:SUITE 503
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3463
Practice Address - Country:US
Practice Address - Phone:813-844-7000
Practice Address - Fax:813-254-6440
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS13135207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program