Organization Active NPI

Florencio T. Lizama

  • Specialist
  • Tamuning, GU
National Provider Identifier
1255484275
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MOOO938 Issued in GU
Legal business name
FLORENCIO T. LIZAMA
Practice address
177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161
Phone
(671) 647-6201
Fax
(671) 649-4507
NPI assigned
Jan 21, 2007
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Pauline Sa Lizama
Title
Clinic Manager
Phone
(671) 477-4215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MOOO938 GU Primary

Addresses

Primary practice location

177 Chalan Pasaheru Ste C
Tamuning, GU 96913-4161

Mailing address

PO Box 3431
Hagatna, GU 96932-3431
Phone (671) 477-4215

National Provider Directory

National Provider Directory

Locations

241 Farenholt Ave
Ste 204
Tamuning, GU 96913
Phone (671) 647-4542

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1255484275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3431",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969323431",
            "telephone_number": "671-477-4215",
            "fax_number": "671-477-4215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 CHALAN PASAHERU STE C",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134161",
            "telephone_number": "671-647-6201",
            "fax_number": "671-649-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORENCIO T. LIZAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-21",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "LIZAMA",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "SA",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "671-477-4215"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GU",
            "license": "MOOO938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.