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Individual

DONALD WALTER LIEBELT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3515 SE 17TH ST, OCALA, FL 34471
(352) 509-9165
(352) 861-7725
Mailing address
3515 SE 17TH ST, OCALA, FL 34471-5586
(352) 509-9165
(352) 861-7725

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME56468
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10600
BCBS FL
FL
Enumeration date
11/14/2005
Last updated
10/23/2019
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