Active NPI
Lisandra Reyes Garcia
- Surgery Physician
- Hollywood, FL
National Provider Identifier
1194480459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 21-549
- Practice address
- 931 N 74TH Ter
Hollywood, FL 33024-5343 - Phone
- (754) 779-1097
- NPI assigned
- Nov 2, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 21-549 | FL | Primary |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21-549 | FL | MD | Surgery 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": "1635811200000",
"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": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "21-549",
"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 Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.