MEDICARE: ELIZABETH HATZ D.O.

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	207Q00000X	Family Medicine Physician	OS12757	FL
2	207Q00000X	Family Medicine Physician	UO 3151	FL
3	207P00000X	Emergency Medicine Physician	OP61556836	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1519W	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467705640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH HATZ D.O.

Provider Business Mailing Address
First Line	:	14690 SPRING HILL DR
Second Line	:	SUITE 101
City	:	SPRING HILL
State	:	FL
Zip	:	34609-8102
Country	:	US
Telephone Number	:	352-799-0046
Fax Number	:	352-799-0042

Provider Business Practice Location Address
First Line	:	1700 SE HILLMOOR DR STE 501
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7536
Country	:	US
Telephone Number	:	772-212-7049
Fax Number	:	772-212-7059

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

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	02/03/2026

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Directions to “ ELIZABETH HATZ D.O.” Practice Location

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