Individual
DR. JEFFREY LISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
211 SE 12TH AVE, FORT LAUDERDALE, FL 33301-3637
(954) 462-4322
(954) 467-3338
Mailing address
211 SE 12TH AVE, FORT LAUDERDALE, FL 33301-3637
(954) 462-4322
(954) 467-3338
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
PO1197
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO1197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029616300
—
FL
Enumeration date
07/31/2006
Last updated
07/29/2010
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