Provider Demographics
NPI:1669451670
Name:GLEIBERMAN, IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:
Last Name:GLEIBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 FAIRWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4204
Mailing Address - Country:US
Mailing Address - Phone:561-712-6265
Mailing Address - Fax:561-712-7349
Practice Address - Street 1:1000 36TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4862
Practice Address - Country:US
Practice Address - Phone:772-567-9711
Practice Address - Fax:772-563-4574
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40064207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251880500Medicaid
FL94341SMedicare PIN
FL94341TMedicare PIN
FL94341RMedicare PIN
FLD63217Medicare UPIN
FL94341XMedicare PIN