Healthcare Provider Details

I. General information

NPI: 1942214226
Provider Name (Legal Business Name): LIZA M COLIMON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIZA MARIE SWEDARSKY MD

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 COLUMBIA ST SUITE 101
ORLANDO FL
32806-1133
US

IV. Provider business mailing address

75 FRANCIS ST SUITE 101
BOSTON MA
02115-6110
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5560
  • Fax: 321-841-2442
Mailing address:
  • Phone: 617-732-4840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number229607
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME103808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: