Individual provider Active NPI

Frederick Byron Liebler, M.D.

  • Specialist
  • Boca Raton, FL
National Provider Identifier
1104814417
Registry record updated Jun 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME16158 Issued in FL
Practice address
670 Glades Rd
Suite 300
Boca Raton, FL 33431-6461
Phone
(561) 395-2626
Fax
(561) 395-7026
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME16158 FL Primary

Addresses

Primary practice location

670 Glades Rd
Suite 300
Boca Raton, FL 33431-6461

Mailing address

670 Glades Rd
Suite 300
Boca Raton, FL 33431-6461
Phone (561) 395-2626

Other identifiers 1

IdentifierTypeStateIssuer
373658000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1104814417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "SUITE 300",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-395-2626",
            "fax_number": "561-395-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GLADES RD",
            "address_2": "SUITE 300",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316461",
            "telephone_number": "561-395-2626",
            "fax_number": "561-395-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLER",
        "first_name": "FREDERICK",
        "middle_name": "BYRON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME16158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373658000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.