Healthcare Provider Details

I. General information

NPI: 1053462879
Provider Name (Legal Business Name): VIRGINIA A BIBLER MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4744 SR64
BRADENTON FL
34208
US

IV. Provider business mailing address

828 44TH AVE E
ELLENTON FL
34222-2433
US

V. Phone/Fax

Practice location:
  • Phone: 941-518-5468
  • Fax:
Mailing address:
  • Phone: 941-518-5468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number07900
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: