Ellen Wendy Lebow, D.O

Primary specialty

SpecialistTaxonomy code 174400000X

License

0S5155 Issued in FL

Practice address

21110 Biscayne Blvd
Suite 312
Aventura, FL 33180-1227

Phone

(305) 933-3030

Fax

(305) 933-1436

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487787362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD",
            "address_2": "SUITE 312",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801227",
            "telephone_number": "305-933-3030",
            "fax_number": "305-933-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD",
            "address_2": "SUITE 312",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801227",
            "telephone_number": "305-933-3030",
            "fax_number": "305-933-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBOW",
        "first_name": "ELLEN",
        "middle_name": "WENDY",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "0S5155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80332",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Aventura, FL
• Providers in Aventura, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.