Individual
ERICA LIEBKNECHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1925 MIZELL AVE, WINTER PARK, FL 32792-4106
(407) 646-7931
Mailing address
1925 MIZELL AVE STE 201, WINTER PARK, FL 32792-4155
(407) 335-5077
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9117459
FL
363AS0400X
Surgical Physician Assistant
—
FL
Other
Enumeration date
04/25/2023
Last updated
08/31/2023
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