Provider Demographics
NPI:1811948474
Name:FIEBERT, IRA M (PT, PHD)
Entity type:Individual
Prefix:
First Name:IRA
Middle Name:M
Last Name:FIEBERT
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 LINTON BLVD
Mailing Address - Street 2:SUITE F116
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6584
Mailing Address - Country:US
Mailing Address - Phone:561-498-1423
Mailing Address - Fax:561-498-7848
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:SUITE F116
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-498-1423
Practice Address - Fax:561-498-7848
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT3255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY2556ZMedicare ID - Type Unspecified