Healthcare Provider Details

I. General information

NPI: 1255410288
Provider Name (Legal Business Name): MICHELE F LIBMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 SE MONTEREY RD STE 101
STUART FL
34994-4512
US

IV. Provider business mailing address

1050 SE MONTEREY RD STE 101
STUART FL
34994-4512
US

V. Phone/Fax

Practice location:
  • Phone: 772-419-0560
  • Fax: 772-419-0557
Mailing address:
  • Phone: 772-419-0560
  • Fax: 772-419-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MICHELE F LIBMAN
Title or Position: OWNER
Credential: MD
Phone: 772-419-0560