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General NPI Number Information
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NPI Number | 1427421130
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Entity Type | Organization
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Legal Business Name | LIEBELT FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 11/03/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 3515 SE 17TH ST SUITE 100
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City | OCALA
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State | FL
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Zip | 34471-5586
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Country | US
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Telephone | 352-509-9470
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Fax | 352-861-7725
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Provider Business Mailing Address
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Address Line | 3515 SE 17TH ST SUITE 100
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City | OCALA
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State | FL
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Zip | 34471-5586
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Country | US
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Telephone | 352-509-9470
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Fax | 352-861-7725
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Authorized Official
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Title or Position | CEO
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Name | DR. DONALD W LIEBELT
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Credential | MD
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Telephone | 352-509-9470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0056468
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License Number State | FL
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