Provider Demographics
NPI:1518922285
Name:LIBREROS, JAIRO D (MD PA)
Entity Type:Individual
Prefix:DR
First Name:JAIRO
Middle Name:D
Last Name:LIBREROS
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:36338 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1328
Mailing Address - Country:US
Mailing Address - Phone:727-773-8886
Mailing Address - Fax:727-773-8896
Practice Address - Street 1:36338 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1328
Practice Address - Country:US
Practice Address - Phone:727-773-8886
Practice Address - Fax:727-773-8896
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME639322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF36064Medicare UPIN