Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 111111111 | FL |
NPI | 1184664310 |
---|---|
Provider Name | Jocelyn E Leveque |
First Address | Pensacola, FL 32503-2058 |
Second Address | Pensacola, FL 32503-2058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 28/06/2019 |