MEDICARE: CANDACE MARIE LIEBIG

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	363LF0000X	Family Nurse Practitioner	APRN11045479	FL

General Provider Information

NPI Number	:	1801726435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDACE MARIE LIEBIG

Provider Business Mailing Address
First Line	:	4344 WORTHINGTON CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-1154
Country	:	US
Telephone Number	:	727-631-3562
Fax Number	:

Provider Business Practice Location Address
First Line	:	4344 WORTHINGTON CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-1154
Country	:	US
Telephone Number	:	727-631-3562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2026
Last Update Date	:	05/23/2026

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Directions to “ CANDACE MARIE LIEBIG ” Practice Location

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