Individual
MALLORY LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6931 W BROWARD BLVD, PLANTATION, FL 33317-2902
(954) 321-5191
Mailing address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-1250
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9119379
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/06/2023
Last updated
12/09/2024
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