Provider Demographics
NPI:1447458658
Name:JOHN D. CORBITT, JR. M.D., INC
Entity type:Organization
Organization Name:JOHN D. CORBITT, JR. M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONETTI
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:561-439-1501
Mailing Address - Street 1:10415 OAK MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5470
Mailing Address - Country:US
Mailing Address - Phone:561-649-8629
Mailing Address - Fax:561-439-9902
Practice Address - Street 1:142 JFK DRIVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-439-1500
Practice Address - Fax:561-439-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty