Individual provider Active NPI

Maria Eugenia Lizardi, M.A.

  • Psychologist
  • Vega Baja, PR
National Provider Identifier
1053631895
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
001718 Issued in PR
Practice address
Rod. 155 KM 58.5 Bo. Pugnado Adentro
Vega Baja, PR 00693
Phone
(787) 642-0035
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 001718 PR Primary

Addresses

Primary practice location

Rod. 155 KM 58.5 Bo. Pugnado Adentro
Vega Baja, PR 00693

Mailing address

PO Box 1773
Ciales, PR 00638-1773
Phone (787) 854-7392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625001227 FL Practitioner - Mental Health Counselor 8123561651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
001718PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychologist CurrentSince May 17, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1053631895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1773",
            "city": "CIALES",
            "state": "PR",
            "postal_code": "006381773",
            "telephone_number": "787-854-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROD. 155 KM 58.5 BO. PUGNADO ADENTRO",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00693",
            "telephone_number": "787-642-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZARDI",
        "first_name": "MARIA",
        "middle_name": "EUGENIA",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "001718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

Verify at the official NPI Registry.