Individual
ABBEY ROSE LIEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-8613
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT34971
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104079000
—
FL
01
—
LQ514
MEDICARE
FL
01
—
Y911W
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/15/2019
Last updated
11/12/2020
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