Provider Demographics
NPI:1548570278
Name:CAREY, LILIBETH R (PT)
Entity Type:Individual
Prefix:
First Name:LILIBETH
Middle Name:R
Last Name:CAREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 ROYAL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-4393
Mailing Address - Country:US
Mailing Address - Phone:845-206-1112
Mailing Address - Fax:904-473-0263
Practice Address - Street 1:313 ROYAL LAKE DR
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-4393
Practice Address - Country:US
Practice Address - Phone:845-206-1112
Practice Address - Fax:904-473-0263
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016153-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist