Individual
JESSE LEBARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
8451 SHADE AVE STE 205, SARASOTA, FL 34243-2878
(941) 360-2477
(941) 360-2577
Mailing address
8451 SHADE AVE STE 205, SARASOTA, FL 34243-2878
(941) 360-2477
(941) 360-2577
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA9111415
FL
363AM0700X
Medical Physician Assistant
Primary
PA9111415
FL
Other
Enumeration date
07/29/2018
Last updated
12/17/2021
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