Healthcare Provider Details

I. General information

NPI: 1407071004
Provider Name (Legal Business Name): AARON H LIEBMAN AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 37TH PLACE
VERO BEACH FL
32960
US

IV. Provider business mailing address

925 37TH PLACE
VERO BEACH FL
32960
US

V. Phone/Fax

Practice location:
  • Phone: 772-562-5100
  • Fax: 772-562-5938
Mailing address:
  • Phone: 772-562-5100
  • Fax: 772-562-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY1050
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: