Provider Demographics
NPI:1932695277
Name:JAIRO D LIBREROS-CUPIDO MD PA
Entity Type:Organization
Organization Name:JAIRO D LIBREROS-CUPIDO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIBREROS-CUPIDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-773-8886
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 1:4914 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1402
Practice Address - Country:US
Practice Address - Phone:813-876-7246
Practice Address - Fax:813-871-1437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty