Individual
ELLEN WENDY LEBOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
21110 BISCAYNE BLVD, SUITE 312, AVENTURA, FL 33180-1227
(305) 933-3030
(305) 933-1436
Mailing address
21110 BISCAYNE BLVD, SUITE 312, AVENTURA, FL 33180-1227
(305) 933-3030
(305) 933-1436
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0S5155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80332
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/13/2007
Last updated
07/08/2007
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