Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS9810 | FL |
N | 207Q00000X | Family Doctor | OS9810 | FL |
NPI | 1437369477 |
---|---|
Provider Name | Dr. James D. Leiber |
First Address | Sarasota, FL 34243-2894 |
Second Address | Sarasota, FL 34243-2894 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BG053Y | (02) | FL |