| Liberty Personal Llc | |
|
9911 Corkscrew Rd Ste 200 Estero FL 33928-3323 | |
| (239) 237-5500 | |
| (888) 828-5797 |
| Full Name | Liberty Personal Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9911 Corkscrew Rd Ste 200, Estero, Florida |
| Authorized Official Name and Position | Gregory M Romanuik (PRESIDENT, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2392375500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Personal Llc 9911 Corkscrew Rd Ste 200 Estero FL 33928-3323 Ph: (239) 237-5500 | Liberty Personal Llc 9911 Corkscrew Rd Ste 200 Estero FL 33928-3323 Ph: (239) 237-5500 |
| NPI Number | 1396307062 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 02/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396307062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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