Provider Demographics
NPI:1588861314
Name:LIBERO, PETER VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:VINCENT
Last Name:LIBERO
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9550 E COLUMBUS DR
Mailing Address - Street 2:HCSO OHWC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7715
Mailing Address - Country:US
Mailing Address - Phone:813-242-5565
Mailing Address - Fax:813-769-8730
Practice Address - Street 1:9550 E COLUMBUS DR
Practice Address - Street 2:HCSO OHWC
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7715
Practice Address - Country:US
Practice Address - Phone:912-427-0870
Practice Address - Fax:912-427-1250
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2016-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 122257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine