Healthcare Provider Details

I. General information

NPI: 1639182033
Provider Name (Legal Business Name): ELIZABETH SHUGERT WILLINGHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH SHUGERT M.D.

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST FL 5
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST FL 5
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-3564
  • Fax:
Mailing address:
  • Phone: 305-243-3564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number179002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: