Individual provider Active NPI

Lisandra Reyes Garcia

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1194480459
Registry record updated Oct 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11051935 Issued in FL
Practice address
931 N 74TH Ter
Hollywood, FL 33024-5343
Phone
(754) 779-1097
NPI assigned
Nov 2, 2021
Last updated
Oct 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11051935 FL Primary
Surgery Physician 208600000X 21-549 FL

Addresses

Primary practice location

931 N 74TH Ter
Hollywood, FL 33024-5343

Mailing address

931 N 74TH Ter
Hollywood, FL 33024-5343
Phone (754) 779-1097

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

State licenses

LicenseStateTypeSpecialty
21-549FLMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1194480459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 N 74TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245343",
            "telephone_number": "754-779-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 N 74TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245343",
            "telephone_number": "754-779-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES GARCIA",
        "first_name": "LISANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11051935",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "21-549",
            "primary": false
        }
    ],
    "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 Oct 30, 2026; 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.