Provider Demographics
NPI:1487775789
Name:LEBEN, BOBBI K (MD)
Entity type:Individual
Prefix:DR
First Name:BOBBI
Middle Name:K
Last Name:LEBEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BOBBI
Other - Middle Name:LYNN
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:95360 OVERSEAS HWY STE 11
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2038
Mailing Address - Country:US
Mailing Address - Phone:920-279-1041
Mailing Address - Fax:
Practice Address - Street 1:95360 OVERSEAS HWY STE 11
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2038
Practice Address - Country:US
Practice Address - Phone:305-296-2212
Practice Address - Fax:305-296-2209
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49013-020208100000X
FLME116235208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation