Organization
DENNIS M LISTON MD PA
Active
Other names
Dennis M Liston M.D. P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS MICHAEL LISTON M.D. P.A (CEO)
(954) 492-4525
Entity
Organization
Contact information
Practice address
2151 E COMMERCIAL BLVD, SUITE 304, FORT LAUDERDALE, FL 33308-4347
(954) 492-4525
Mailing address
2151 E COMMERCIAL BLVD, SUITE 304, FORT LAUDERDALE, FL 33308-4347
(954) 492-4525
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME-0059446
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277406200
—
FL
Enumeration date
08/12/2006
Last updated
07/22/2013
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