Provider Demographics
NPI:1730387218
Name:LUBIN, LEAH R (LIC AP)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:R
Last Name:LUBIN
Suffix:
Gender:F
Credentials:LIC AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13314 THOMASVILLE CIR APT C
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-9545
Mailing Address - Country:US
Mailing Address - Phone:813-245-5649
Mailing Address - Fax:
Practice Address - Street 1:3016 LAND O LAKES BLVD
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-4918
Practice Address - Country:US
Practice Address - Phone:813-909-7376
Practice Address - Fax:813-949-8481
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2358171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist