Provider Demographics
NPI:1437369477
Name:LEIBER, JAMES D (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:LEIBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2401 UNIVERSITY PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2894
Mailing Address - Country:US
Mailing Address - Phone:941-357-1773
Mailing Address - Fax:941-256-7452
Practice Address - Street 1:2401 UNIVERSITY PKWY STE 104
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2894
Practice Address - Country:US
Practice Address - Phone:941-357-1773
Practice Address - Fax:941-256-7452
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9810207Q00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBG053YMedicare UPIN