Provider Demographics
NPI:1174502041
Name:LIEBERMAN, DEBORAH M (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7144 NW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21644 STATE ROAD 7
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1842
Practice Address - Country:US
Practice Address - Phone:561-488-8000
Practice Address - Fax:904-346-0113
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0008578207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10027OtherBCBS
FL263580100Medicaid
FL263580100Medicaid
FL10027AMedicare ID - Type Unspecified