MEDICARE: LIBERTY MEDICAL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336M0002X	Mail Order Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	0206008304	OTHER	VA	RESIDENT HME/DME LICENSE
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
29	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285636704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY MEDICAL, LLC

Provider Business Mailing Address
First Line	:	6700 N ANDREWS AVE STE 700
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2199
Country	:	US
Telephone Number	:	772-398-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 N ANDREWS AVE STE 700
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-2199
Country	:	US
Telephone Number	:	772-398-5800
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	EDWARD KUNZWEILER
Credential	:
Telephone Number	:	772-398-5870

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	05/08/2025

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