| Liberty Physicians Associates Inc | |
|
1250 W State Road 434 Ste 1016 Longwood FL 32750-4969 | |
| (833) 438-0008 | |
| Not Available |
| Full Name | Liberty Physicians Associates Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1250 W State Road 434 Ste 1016, Longwood, Florida |
| Authorized Official Name and Position | Oladimeji J Adekunle (MANAGING DIRECTOR) |
| Authorized Official Contact | 8334380008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Physicians Associates Inc 1250 W State Road 434 Ste 1016 Longwood FL 32750-4969 Ph: (833) 438-0008 | Liberty Physicians Associates Inc 1250 W State Road 434 Ste 1016 Longwood FL 32750-4969 Ph: (833) 438-0008 |
| NPI Number | 1376181446 |
|---|---|
| Provider Enumeration Date | 12/19/2019 |
| Last Update Date | 12/19/2019 |
| Medicare PECOS PAC ID | 3870920853 |
|---|---|
| Medicare Enrollment ID | O20200304001002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376181446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Melissa C Kirby |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184627374 PECOS PAC ID: 1850388638 Enrollment ID: I20041104000955 |
| Provider Name | Rory C Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043522915 PECOS PAC ID: 9638307564 Enrollment ID: I20150728003524 |
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