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Individual

MRS. LYZZA ARCHIPOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3487 BROADWAY AVENUE, FORT MYERS, FL 33901-7213
(239) 334-9555
(239) 334-2439
Mailing address
3487 BROADWAY AVENUE, FORT MYERS, FL 33901-7213
(239) 334-9555
(239) 334-2439

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
10/24/2007
Last updated
05/16/2016
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