Organization Active NPI

Fred a Liebowitz MD PA

  • Pain Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1275723520
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
ME60344 Issued in FL
Legal business name
FRED A LIEBOWITZ MD PA
Doing business as
HEADACHE & PAIN MANAGEMENT OF SWFL
Practice address
6150 Diamond Centre CT
700-1
Fort Myers, FL 33912-4365
Phone
(239) 278-1000
Fax
(239) 278-0501
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Dr. Fred Allan Liebowitz, MDNPI 1801892633
Title
Owner/President
Phone
(239) 278-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X ME60344 FL Primary

Addresses

Primary practice location

6150 Diamond Centre CT
700-1
Fort Myers, FL 33912-4365

Mailing address

6150 Diamond Centre CT
700-1
Fort Myers, FL 33912-4365
Phone (239) 278-1000

Other names 1

  • HEADACHE & PAIN MANAGEMENT OF SWFL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000941 FL Part B Supplier - Clinic/Group Practice 9133020803 Receives reassigned benefits from 2 practitioners
Practice locations: Ft Myers, FL

National Provider Directory

National Provider Directory

Locations

6150 Diamond Centre Ct
Unit 701
Fort Myers, FL 33912

6150 Diamond Centre Ct
Ste 7001
Fort Myers, FL 33912
Phone (239) 278-1000

6150 Diamond Centre Ct
#700
Fort Myers, FL 33912

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1275723520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "700-1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-278-1000",
            "fax_number": "239-278-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 DIAMOND CENTRE CT",
            "address_2": "700-1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124365",
            "telephone_number": "239-278-1000",
            "fax_number": "239-278-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED A LIEBOWITZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "LIEBOWITZ",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "239-278-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME60344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEADACHE & PAIN MANAGEMENT OF SWFL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.