Individual
MRS. KAYLYN PLUM LIEBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 821-8038
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA9119787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127523000
—
FL
01
—
8RUV4
BCBS
FL
Enumeration date
10/12/2016
Last updated
03/23/2026
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