Individual
MIGUEL LIZARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12470 TELECOM DR STE 300W, TEMPLE TERRACE, FL 33637-0904
(813) 871-8183
(813) 871-8184
Mailing address
12485 HITCHING ST, ODESSA, FL 33556-3852
(508) 904-7243
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
218399
MA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
ME135155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134217
—
MA
Enumeration date
06/08/2006
Last updated
01/08/2020
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