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General NPI Number Information
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NPI Number | 1174384200
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Entity Type | Individual
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Provider Name | LIZ ESTEFANI LEE
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Gender | Female
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 34866 US 19 N UNIT 27
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City | PALM HARBOR
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State | FL
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Zip | 34684-1918
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Country | US
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Telephone | 727-755-0064
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 GREEN ACRES AVE APT B
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City | LARGO
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State | FL
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Zip | 33771-2649
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Country | US
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Telephone | 727-459-3329
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11027487
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License Number State | FL
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