Individual provider Active NPI

Lorraine Dee Dalisay Izquierdo, NP

  • Family Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1043099369
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11028841 Issued in FL
Practice address
5810 Sheridan St
Hollywood, FL 33021-3244
Phone
(954) 251-2381
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11028841 FL Primary

Addresses

Primary practice location

5810 Sheridan St
Hollywood, FL 33021-3244

Mailing address

5810 Sheridan St
Hollywood, FL 33021-3244
Phone (954) 251-2381

Other practice location 1

401 E Oakland Park Blvd
Oakland Park, FL 33334-2149
Phone (305) 780-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11028841FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center International Inc CurrentSince Oct 1, 2023 Accepting new patients
Medical Center International Inc CurrentSince Jan 17, 2021 Accepting new patients

Locations

5810 Sheridan St
Hollywood, FL 33021
Phone (954) 251-2381

401 E Oakland Park Blvd
Oakland Park, FL 33334
Phone (305) 780-0009

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1043099369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213244",
            "telephone_number": "954-251-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213244",
            "telephone_number": "954-251-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 E Oakland Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakland Park",
            "state": "FL",
            "postal_code": "333342149",
            "country_code": "US",
            "telephone_number": "305-780-0009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "LORRAINE DEE",
        "middle_name": "DALISAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11028841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.