Provider Demographics
NPI:1184715567
Name:GZYL, LILIOZA MARIA (MD)
Entity type:Individual
Prefix:
First Name:LILIOZA
Middle Name:MARIA
Last Name:GZYL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3005 SPRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46808
Mailing Address - Country:US
Mailing Address - Phone:260-483-2366
Mailing Address - Fax:260-471-3644
Practice Address - Street 1:1415 DIRECTORS ROW
Practice Address - Street 2:STE 11A
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46808
Practice Address - Country:US
Practice Address - Phone:260-460-4959
Practice Address - Fax:260-471-3644
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036326A208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology