MEDICARE: LIZA JEAN MEYERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	IMH27980	FL

General Provider Information

NPI Number	:	1063300291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZA JEAN MEYERS

Provider Business Mailing Address
First Line	:	5280 SUMMERLIN COMMONS WAY STE 804
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-2160
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12620 WORLD PLAZA LN UNIT 1
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3996
Country	:	US
Telephone Number	:	239-826-3655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	11/04/2025

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Directions to “ LIZA JEAN MEYERS ” Practice Location

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