Provider Demographics
NPI:1750649901
Name:LIEBLER, CASSIDY N (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:CASSIDY
Middle Name:N
Last Name:LIEBLER
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:MS
Other - First Name:CASSIDY
Other - Middle Name:N
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-C
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-554-8384
Practice Address - Fax:813-443-8160
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0058001-00Medicaid
FL0058001-00Medicaid