Liebetreu, Mark Ernest
Liebetreu, Mark Ernest is an individual health care provider with primary practice located at 6091 S Pointe Blvd , Ft Myers FL 33919-4899. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Liebetreu, Mark Ernest can be contacted via phone (239) 985-7171.Contact Information
Primary practice address
6091 S Pointe Blvd
Ft Myers FL 33919-4899
Phone: (239) 985-7171
Fax: (239) 985-7118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OP0002191 | Florida |
Profile Details
| NPI number | 1639167943 |
|---|---|
| LBN Legal business name | Liebetreu, Mark Ernest |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Feb 8th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639167943 | NPPES |
| Florida | Other | PG040 | PTAN |
| Florida | MEDICAID | 620041900 | PTAN |
| Florida | Other | 20537 | PTAN |
| Florida | Other | 20537Z | PTAN |
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