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General NPI Number Information
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NPI Number | 1033064548
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Entity Type | Organization
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Legal Business Name | LIZWELL LLC
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 17011 STATE ROAD 50
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City | CLERMONT
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State | FL
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Zip | 34711-8203
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Country | US
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Telephone | 352-353-2208
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Fax | 352-227-3975
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Provider Business Mailing Address
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Address Line | 19941 EAGLE RUN FL 34736
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City | GROVELAND
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State | FL
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Zip | 34736-8401
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Country | US
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Telephone | 757-672-5073
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Fax | 757-672-5073
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELIZABETH JEAN HUMBERT
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Credential | MSN, APRN, FNP-BC
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Telephone | 757-672-5073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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