| Liberty Medical Llc | |
|
443 Lucerne Ave Tampa FL 33606-3838 | |
| (570) 677-4001 | |
| Not Available |
| Full Name | Liberty Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 443 Lucerne Ave, Tampa, Florida |
| Authorized Official Name and Position | Mehul Suman Patel (OWNER) |
| Authorized Official Contact | 5706774001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Medical Llc 443 Lucerne Ave Tampa FL 33606-3838 Ph: (570) 677-4001 | Liberty Medical Llc 443 Lucerne Ave Tampa FL 33606-3838 Ph: (570) 677-4001 |
| NPI Number | 1790466258 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Medicare PECOS PAC ID | 4688029861 |
|---|---|
| Medicare Enrollment ID | O20231007000230 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790466258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mehul Suman Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346504123 PECOS PAC ID: 4587964135 Enrollment ID: I20161010001942 |
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