MEDICARE: CAROL B. LIEBERMAN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	ARNP1185222	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y6819	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891774642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL B. LIEBERMAN ARNP

Provider Business Mailing Address
First Line	:	2201 S. OCEAN DRIVE
Second Line	:	APT 1001
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019
Country	:	US
Telephone Number	:	305-968-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 S OCEAN DR
Second Line	:	1001
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2539
Country	:	US
Telephone Number	:	305-968-4474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	05/06/2011

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