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General NPI Number Information
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NPI Number | 1215228572
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Entity Type | Individual
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Provider Name | JAIME MICHELLE LIBES-BANDER MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 92 W MILLER ST # MP318
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City | ORLANDO
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State | FL
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Zip | 32806-2032
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Country | US
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Telephone | 321-841-8588
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Fax | 321-841-8560
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Provider Business Mailing Address
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Address Line | 92 W MILLER ST # MP318
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City | ORLANDO
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State | FL
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Zip | 32806-2032
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Country | US
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Telephone | 321-841-8588
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Fax | 321-841-8560
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD49195
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101248768
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 036-136820
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License Number State | IL
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