Healthcare Provider Details

I. General information

NPI: 1750834081
Provider Name (Legal Business Name): RACHEL BRENNA LIEBERMAN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL BRENNA LIEBERMAN AUD

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 W 8TH ST
JACKSONVILLE FL
32209-6511
US

IV. Provider business mailing address

PO BOX 44008
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-383-1017
  • Fax: 904-244-7454
Mailing address:
  • Phone: 904-383-1017
  • Fax: 904-244-7454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY2980
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: