Provider Demographics
NPI:1558055376
Name:ROLON, LIZ JENIFFER
Entity Type:Individual
Prefix:
First Name:LIZ
Middle Name:JENIFFER
Last Name:ROLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LILY PAD RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:33839-5149
Mailing Address - Country:US
Mailing Address - Phone:407-627-5920
Mailing Address - Fax:
Practice Address - Street 1:211 LILY PAD RD
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:FL
Practice Address - Zip Code:33839-5149
Practice Address - Country:US
Practice Address - Phone:407-627-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management