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General NPI Number Information
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NPI Number | 1326124629
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Entity Type | Individual
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Provider Name | EVA LEIGH LIZER M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 119 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-5779
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Country | US
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Telephone | 904-399-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 16 TOON LN
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City | LEE
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State | NH
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Zip | 03861-6507
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Country | US
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Telephone | 617-645-5273
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 221159
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35093237
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME160941
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License Number State | FL
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