Healthcare Provider Details

I. General information

NPI: 1437101904
Provider Name (Legal Business Name): MARK A. LIBERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SW HEALTH PKWY STE 205
NAPLES FL
34109-0473
US

IV. Provider business mailing address

2234 COLONIAL BLVD ATTN: MANAGED CARE DEPT.
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 239-449-7979
  • Fax: 239-593-3356
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberFLME0078783
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: