Individual
KATHERINE LIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD PHD
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-5820
(239) 343-4098
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-5820
(239) 343-4098
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
0101252774
VA
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
ME166042
FL
207RC0000X
Cardiovascular Disease Physician
127613
IL
207RC0000X
Cardiovascular Disease Physician
ME166042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194864157
—
FL
Enumeration date
02/06/2007
Last updated
01/02/2025
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