Provider Demographics
NPI:1215041769
Name:MALIBIRAN, FREDERICK (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:MALIBIRAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:2020 TOWN CENTER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-2906
Practice Address - Country:US
Practice Address - Phone:813-315-1500
Practice Address - Fax:813-377-1686
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01205040OtherR&R MEDICARE
FL007922000Medicaid
H05031Medicare UPIN
FL007922000Medicaid