Lisett Mata Alvarez, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN28432 Issued in FL

Practice address

18070 S Tamiami TRL # 101
Fort Myers, FL 33908-4602

Phone

(239) 236-4884

NPI assigned

Jun 15, 2021

Last updated

Jul 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Freedom Health HMO Network

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

• Family Health Centers of Southwest Florida Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1326090390
  NPD (past)
• Family Health Centers of Southwest Florida, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
  • NPI 1356853154
  NPD (past)

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1265000319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 SW SANTA BARBARA PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339148434",
            "telephone_number": "786-916-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18070 S TAMIAMI TRL # 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084602",
            "telephone_number": "239-236-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA ALVAREZ",
        "first_name": "LISETT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Massolio, APRN
• Amber Mastaso
• Lauren Chandler Masters, APRN
• Dante John Mastrangelo
• Sophia Mastros
• Otakhon Matchanov, MD
• Nathalie Mateo
• Maternal Fetal Medicine of Southwest Florida PA
• Melissa L. Matherson, LMFT
• Mini Mathew, APRN

• Dentist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.