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General NPI Number Information
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NPI Number | 1619970738
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Entity Type | Individual
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Provider Name | EDWIN LIU M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 12959 PALMS WEST DR STE 120
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4937
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Country | US
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Telephone | 561-753-8888
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Fax | 561-795-5004
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Provider Business Mailing Address
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Address Line | 12959 PALMS WEST DR STE 120
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4937
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Country | US
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Telephone | 561-753-8888
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Fax | 561-795-5004
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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 | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME79332
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207YS0012X
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Taxonomy Name | Sleep Medicine (Otolaryngology) Physician
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License Number | 79332
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License Number State | FL
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