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General NPI Number Information
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NPI Number | 1073565743
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Entity Type | Individual
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Provider Name | ELIZABETH OTEIZA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 901 N CONGRESS AVE SUITE 104
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-3316
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Country | US
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Telephone | 561-732-8005
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Fax | 561-732-0150
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Provider Business Mailing Address
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Address Line | 17070 GULF PINE CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-6351
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Country | US
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Telephone | 561-793-9097
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME60379
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License Number State | FL
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