Provider Demographics
NPI:1801690664
Name:LEBOEUF, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:LEBOEUF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-7513
Mailing Address - Country:US
Mailing Address - Phone:954-856-4899
Mailing Address - Fax:954-856-4899
Practice Address - Street 1:7022 HARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-7513
Practice Address - Country:US
Practice Address - Phone:954-856-4899
Practice Address - Fax:954-856-4899
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA7330224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant