Individual
SUSAN LEIBMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3515 E FLETCHER AVE, TAMPA, FL 33613-4706
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME52224
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048303600
—
FL
01
—
07167
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/17/2006
Last updated
04/01/2021
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