Provider Demographics
NPI:1265400758
Name:LLIBRE, MARTA (MD)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:LLIBRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:1814 WESTCHESTER DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7369
Practice Address - Country:US
Practice Address - Phone:336-802-2665
Practice Address - Fax:336-802-2026
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91636207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910594Medicaid
FL52077OtherBCBS OF FLORIDA
FL271704200Medicaid
NCP00689718OtherRR MEDICARE
FL52077OtherBCBS OF FLORIDA
FL52077ZMedicare ID - Type Unspecified
NCP00689718OtherRR MEDICARE