Provider Demographics
NPI:1992867477
Name:HUBER, LIZA (DC)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 BRICKELL BAY DR
Mailing Address - Street 2:#1450
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2936
Mailing Address - Country:US
Mailing Address - Phone:305-662-8442
Mailing Address - Fax:
Practice Address - Street 1:825 BRICKELL BAY DR
Practice Address - Street 2:#1450
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2936
Practice Address - Country:US
Practice Address - Phone:305-662-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88803OtherBCBS