Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | ME0075369 | FL |
NPI | 1518162080 |
---|---|
Provider Name | Dr. Victor M. Lizardo |
First Address | Belle Glade, FL 33430-3427 |
Second Address | Belle Glade, FL 33430-3427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 09/07/2007 |