Healthcare Provider Details

I. General information

NPI: 1144215237
Provider Name (Legal Business Name): FRANK P FILIBERTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 PALM BAY RD NE STE 6W
PALM BAY FL
32905-2937
US

IV. Provider business mailing address

2105 PALM BAY RD NE STE 6W
PALM BAY FL
32905-2937
US

V. Phone/Fax

Practice location:
  • Phone: 321-676-3101
  • Fax: 321-984-4456
Mailing address:
  • Phone: 321-676-3101
  • Fax: 321-984-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME32703
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: