Liberty Physicians Associates Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIBERTY PHYSICIANS ASSOCIATES INC

Practice address

1250 W State Road 434 Ste 1016
Longwood, FL 32750-4969

Phone

(833) 438-0008

NPI assigned

Dec 19, 2019

Last updated

Dec 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Oladimeji J Adekunle

Title

Managing Director

Phone

(833) 438-0008

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rory Williams, MD

  • Family Medicine Physician
  • Bartow, FL
  • NPI 1043522915
  Medicare reassignment NPD
• Kailey Koontz, PA-C

  • Physician Assistant
  • Mount Dora, FL
  • NPI 1477146413
  NPD

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1376181446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434 STE 1016",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "833-438-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W STATE ROAD 434 STE 1016",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504969",
            "telephone_number": "833-438-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY PHYSICIANS ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "ADEKUNLE",
        "authorized_official_first_name": "OLADIMEJI",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "833-438-0008"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freda Leng
• Leon's Compassionate Transport LLC
• Walter Prudden Leonard, DDS
• Jodie Beth Lerner, LMHC
• LHCG Clvii, LLC (Mederi Caretenders)
• Marion Licato, MSW
• Carmelo M Licitra, MD
• Kyra Liebertz
• Lifecare of Central Florida, LLC (LifeCare of Florida)
• Lifecare of Central Florida, LLC (LifeCare Therapy)

• Multi-Specialty Clinic/Center in Longwood, FL
• Providers in Longwood, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.