Healthcare Provider Details

I. General information

NPI: 1609247089
Provider Name (Legal Business Name): ANNELI B. LIEBIG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 E SUNRISE BLVD
FT LAUDERDALE FL
33304-2543
US

IV. Provider business mailing address

2240 E SUNRISE BLVD
FT LAUDERDALE FL
33304-2543
US

V. Phone/Fax

Practice location:
  • Phone: 954-566-8309
  • Fax:
Mailing address:
  • Phone: 954-566-8309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2215212
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: