Provider Demographics
NPI:1376905638
Name:B LIU MD PLLC
Entity type:Organization
Organization Name:B LIU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLESSILDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-419-8924
Mailing Address - Street 1:PO BOX 640524
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34464-0524
Mailing Address - Country:US
Mailing Address - Phone:352-419-8924
Mailing Address - Fax:352-419-8927
Practice Address - Street 1:942 E NORVELL BRYANT HWY
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-2826
Practice Address - Country:US
Practice Address - Phone:352-419-8924
Practice Address - Fax:352-419-8927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty