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General NPI Number Information
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NPI Number | 1811517519
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Entity Type | Individual
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Provider Name | GILI LITWACK
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Gender | Male
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 5770 WILES RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2156
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Country | US
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Telephone | 954-255-5166
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Fax |
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Provider Business Mailing Address
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Address Line | 650 S FEDERAL HWY
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5422
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN25675
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License Number State | FL
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