Individual provider Active NPI

Alec Liederbach, DO

  • Student in an Organized Health Care Education/Training Program
  • Orlando, FL
National Provider Identifier
1205769288
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11431 Issued in FL
Practice address
264 E Rollins Street
6TH Floor
Orlando, FL 32808-5519
Phone
(407) 303-6729
NPI assigned
Jun 8, 2026
Last updated
Jun 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11431 FL Primary

Addresses

Primary practice location

264 E Rollins Street
6TH Floor
Orlando, FL 32808-5519

Mailing address

264 E Rollins Street
6TH Floor
Orlando, FL 32808-5519
Phone (407) 303-6729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616001266 FL Order and Referring Only - NeurologyPractitioner - Neurology 1850863309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1205769288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 E ROLLINS STREET",
            "address_2": "6TH FLOOR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085519",
            "telephone_number": "407-303-6729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 E ROLLINS STREET",
            "address_2": "6TH FLOOR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328085519",
            "telephone_number": "407-303-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDERBACH",
        "first_name": "ALEC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "11431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.