Provider Demographics
NPI:1750764148
Name:FITZPATRICK, LIAM (MD)
Entity type:Individual
Prefix:DR
First Name:LIAM
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:M
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:LIAM FITZPATRICK
Mailing Address - Street 2:333 S TAMIAMI TR SUITE 101
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285
Mailing Address - Country:US
Mailing Address - Phone:941-375-3006
Mailing Address - Fax:941-218-4825
Practice Address - Street 1:RESTORE MEDICAL PARTNERS
Practice Address - Street 2:333 S TAMIAMI TR SUITE 101
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285
Practice Address - Country:US
Practice Address - Phone:941-375-3006
Practice Address - Fax:941-218-4825
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME145835207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program