Provider Demographics
NPI:1528156833
Name:FRANK P FILIBERTO MD PA
Entity type:Organization
Organization Name:FRANK P FILIBERTO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:FILIBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-676-3101
Mailing Address - Street 1:2105 PALM BAY RD NE STE 6W
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2937
Mailing Address - Country:US
Mailing Address - Phone:321-676-3101
Mailing Address - Fax:321-984-4456
Practice Address - Street 1:2105 PALM BAY RD NE STE 6W
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2937
Practice Address - Country:US
Practice Address - Phone:321-676-3101
Practice Address - Fax:321-984-4456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME32703207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066532100Medicaid
FLD51295Medicare UPIN