Liberty Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LIBERTY MEDICAL SUPPLY LLC

Practice address

1700 N Dixie Hwy Ste 116
Boca Raton, FL 33432-1807

Phone

(844) 397-5011

NPI assigned

Aug 18, 2020

Organization subpart

No

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

Authorized official

Name

Ivan Ashley Ferguson

Title

Owner

Phone

(844) 397-5011

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiffany Rae Tino, COTA

  • Occupational Therapy Assistant
  • Boca Raton, FL
  • NPI 1386364958
  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1194337683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY STE 116",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321807",
            "telephone_number": "844-397-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY STE 116",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321807",
            "telephone_number": "844-397-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-397-5011"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Lezell
• LG Behavior Analysis LLC
• LHH LLC
• Li Y Shi
• Xiaorong Li
• Nick Libian, DC, MS
• Mark Libow, M.D.
• Lawrence Russell Libsch, MD
• Tina-Marie A Liburd, NAIL TECHNICIAN
• Jessica Licalzi

• Durable Medical Equipment & Medical Supplies in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.