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NPI Code Detail

MEDICARE: LISA KOTZEN

MEDICARE: LISA KOTZEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1164369781
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA KOTZEN
Provider Business Mailing Address
First Line : 1100 S MIAMI AVE APT 4208
Second Line :
City : MIAMI
State : FL
Zip : 33130-4181
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5030 BRUNSON DR
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-2412
Country : US
Telephone Number : 305-284-3666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2026
Last Update Date : 05/09/2026

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Directions to “ LISA KOTZEN ” Practice Location

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