MEDICARE: DR. LILI ANNA BUZSAKI M.D.

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	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	ME137103	FL
2	2083P0901X	Public Health & General Preventive Medicine Physician	1255710083	KY
3	208D00000X	General Practice Physician	ME137103	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255710083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LILI ANNA BUZSAKI M.D.

Provider Business Mailing Address
First Line	:	910 PINELLAS BAYWAY S APT 205
Second Line	:
City	:	TIERRA VERDE
State	:	FL
Zip	:	33715-2125
Country	:	US
Telephone Number	:	201-957-5681
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 N WHEELER ST # 410
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33563-1860
Country	:	US
Telephone Number	:	201-957-5681
Fax Number	:

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

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	06/12/2023

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