Individual
BLAKE LIEBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8201 W BROWARD BLVD, PLANTATION, FL 33324-2701
(954) 473-6600
Mailing address
8201 W BROWARD BLVD, PLANTATION, FL 33324-2701
(954) 473-6600
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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