Liberty House Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

10D207494 Issued in FL

Legal business name

LIBERTY HOUSE INC

Practice address

504 SE 22ND St
Fort Lauderdale, FL 33316-3472

Phone

(954) 523-1167

NPI assigned

Apr 1, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Robert Underwood

Title

Manager

Phone

(954) 523-1167

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1124446703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 NW 48TH DR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334313335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 SE 22ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333163472",
            "telephone_number": "954-523-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-523-1167",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "10D207494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D207494",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthea Li, SLP
• Karina Isabel Li
• Liaison NP LLC
• Liat Zakay LLC
• Brooke Liberman, O.D.
• Liberty Medical, LLC
• Liberty Medical, LLC
• Liberty Medical, LLC
• Liberty Pharmacy LLC
• Beatriz A. Libos, PA-C

• Clinical Medical Laboratory in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.