MEDICARE: MARK A LIEBERFARB MD PA

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	208800000X	Urology Physician	ME0048840	FL

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

General Provider Information

NPI Number	:	1952624298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK A LIEBERFARB MD PA

Provider Business Mailing Address
First Line	:	6894 LAKE WORTH RD
Second Line	:	SUITE 204
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2964
Country	:	US
Telephone Number	:	561-641-4044
Fax Number	:	561-641-8524

Provider Business Practice Location Address
First Line	:	6894 LAKE WORTH RD
Second Line	:	SUITE 204
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2964
Country	:	US
Telephone Number	:	561-641-4044
Fax Number	:	561-641-8524

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK A LIEBERFARB
Credential	:	MD
Telephone Number	:	561-641-4044

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	11/30/2012

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