Organization Active NPI

Jairo D Libreros MD PA

  • Neurology Physician
  • Palm Harbor, FL
National Provider Identifier
1811080880
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME63932 Issued in FL
Legal business name
JAIRO D LIBREROS MD PA
Practice address
36338 US Highway 19 N
Palm Harbor, FL 34684-1329
Phone
(813) 876-7246
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Authorized official

Name
Mrs. Luz Divina Libreros
Title
Billing Coordinator
Phone
(813) 876-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME63932 FL Primary

Addresses

Primary practice location

36338 US Highway 19 N
Palm Harbor, FL 34684-1329

Mailing address

PO Box 22807
Tampa, FL 33622-2807
Phone (813) 876-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051010000109 FL Part B Supplier - Clinic/Group Practice 5698790681 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

36338 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 773-8886

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334275200000",
    "number": "1811080880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22807",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336222807",
            "telephone_number": "813-876-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36338 US HIGHWAY 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841329",
            "telephone_number": "813-876-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAIRO D LIBREROS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-04-13",
        "status": "A",
        "authorized_official_last_name": "LIBREROS",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "DIVINA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "813-876-7246",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME63932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.