Provider Demographics
NPI:1831235803
Name:LEONBRUNO, JEFFREY J (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:LEONBRUNO
Suffix:
Gender:M
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 POMEROY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5040
Mailing Address - Country:US
Mailing Address - Phone:352-684-9931
Mailing Address - Fax:352-754-9533
Practice Address - Street 1:685 S BROAD ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2844
Practice Address - Country:US
Practice Address - Phone:352-754-9500
Practice Address - Fax:352-754-9533
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6536225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist