Healthcare Provider Details

I. General information

NPI: 1255710083
Provider Name (Legal Business Name): LILI ANNA BUZSAKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 N WHEELER ST # 410
PLANT CITY FL
33563-1860
US

IV. Provider business mailing address

910 PINELLAS BAYWAY S APT 205
TIERRA VERDE FL
33715-2125
US

V. Phone/Fax

Practice location:
  • Phone: 201-957-5681
  • Fax:
Mailing address:
  • Phone: 201-957-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberME137103
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number1255710083
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME137103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: