Provider Demographics
NPI:1477804763
Name:BILD-LIBBIN & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:BILD-LIBBIN & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BILD-LIBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-865-7551
Mailing Address - Street 1:1125 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2443
Mailing Address - Country:US
Mailing Address - Phone:305-865-7551
Mailing Address - Fax:305-864-4820
Practice Address - Street 1:400 W 41ST ST
Practice Address - Street 2:SUITE 406
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-865-7551
Practice Address - Fax:305-864-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2824103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty