Provider Demographics
NPI:1205221652
Name:EPSTEIN, ALIZA (MD)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 S PINE ISLAND RD STE A100
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3118
Mailing Address - Country:US
Mailing Address - Phone:954-741-5555
Mailing Address - Fax:
Practice Address - Street 1:850 S PINE ISLAND RD STE A100
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3118
Practice Address - Country:US
Practice Address - Phone:954-741-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS0667207W00000X
FLME153192207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114049300Medicaid
TX398434601Medicaid