Individual
MRS. FLOR MARITZA LLISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5795 CARRIAGE HILLS DR, AUGUSTA, GA 30907-8208
(912) 980-7342
Mailing address
5795 CARRIAGE HILLS DR, AUGUSTA, GA 30907-8208
(912) 980-7342
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
183500000X
GA
Other
Enumeration date
11/15/2005
Last updated
05/08/2015
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