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General NPI Number Information
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NPI Number | 1841986882
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Entity Type | Organization
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Legal Business Name | LIBANI
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 1907 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3405
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Country | US
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Telephone | 904-388-4712
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 ATLANTIC BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3405
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Country | US
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Telephone | 904-388-4712
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL BARAKAT
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Credential |
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Telephone | 904-962-6005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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