Individual
LIZMAR VEGA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6726 HANLEY RD, TAMPA, FL 33634-4739
(813) 284-7903
Mailing address
6726 HANLEY RD, TAMPA, FL 33634-4739
(813) 284-7903
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1346
FL
208D00000X
General Practice Physician
21764
PR
Other
Enumeration date
05/17/2019
Last updated
06/29/2021
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