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	332B00000X	Durable Medical Equipment & Medical Supplies		FL
2	333600000X	Pharmacy
3	3336M0002X	Mail Order Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	PH28876	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH28876	OTHER	FL	RESIDENT BOARD OF PHARMACY LICENSE
2	10-86493	OTHER		NABP/NCPDP
3	652	OTHER	FL	AHCA HME LICENSE

General Provider Information

NPI Number	:	1881655330
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	:	800-491-3276
Fax Number	:	877-592-8466

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	06/03/2025

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Directions to “LIBERTY MEDICAL, LLC ” Practice Location

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