Organization
DR. LESLY JEAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHILANA ROBINSON DAVIS (MEDICAL ASSISTANT)
(954) 781-3122
Entity
Organization
Contact information
Practice address
321 W ATLANTIC BLVD, STE 102, POMPANO BEACH, FL 33060-6048
(954) 781-3122
(954) 781-0860
Mailing address
321 W ATLANTIC BLVD, STE 102, POMPANO BEACH, FL 33060-6048
(954) 781-3122
(954) 781-0860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
45032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061521800
—
FL
01
—
07927
MEDICARE I.D.
FL
Enumeration date
03/05/2012
Last updated
09/24/2012
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