Healthcare Provider Details

I. General information

NPI: 1972927952
Provider Name (Legal Business Name): NEIL LIFSHUTZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD SUITE 226
OCALA FL
34470-6831
US

IV. Provider business mailing address

19 PECAN DRIVE LOOP
OCALA FL
34472-6249
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-3320
  • Fax:
Mailing address:
  • Phone: 954-661-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW6164
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: