Organization
MA, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LI MA MD, PHD (PRESIDENT)
(813) 345-3937
Entity
Organization
Contact information
Practice address
19260 FISHERMANS BEND DRIVE, LUTZ, FL 33558
(813) 345-3937
Mailing address
19260 FISHERMANS BEND DRIVE, LUTZ, FL 33558
(813) 345-3937
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
FL
Other
Enumeration date
04/06/2007
Last updated
09/11/2025
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