MEDICARE: MR. TRAVIS E LITZ APRN, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11040962	FL

General Provider Information

NPI Number	:	1881586725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TRAVIS E LITZ APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	705 NE 14TH PL UNIT B
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1122
Country	:	US
Telephone Number	:	305-699-7309
Fax Number	:	754-315-2781

Provider Business Practice Location Address
First Line	:	2831 E OAKLAND PARK BLVD
Second Line	:	SUITE 9 PMB 1162
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1803
Country	:	US
Telephone Number	:	786-472-3829
Fax Number	:

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

Provider Enumeration Date	:	07/16/2025
Last Update Date	:	12/22/2025

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