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General NPI Number Information
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NPI Number | 1134963374
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Entity Type | Individual
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Provider Name | SOPHIA LITZKOW
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Gender | Female
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 06/22/2024
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Provider Practice Location Address
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Address Line | 1500 SW 1ST AVE
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City | OCALA
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State | FL
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Zip | 34471-6504
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Country | US
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Telephone | 352-351-7200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | EARLETON
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State | FL
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Zip | 32631-0126
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9513436
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License Number State | FL
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