Individual provider Active NPI

Elizabeth Laquidara, PH.D.

  • Clinical Psychologist
  • Boca Raton, FL
National Provider Identifier
1366496291
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5164 Issued in FL
Practice address
7025 Beracasa Way
102 B
Boca Raton, FL 33433-3443
Phone
(561) 416-7338
Fax
(561) 416-0203
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY5164 FL Primary

Addresses

Primary practice location

7025 Beracasa Way
102 B
Boca Raton, FL 33433-3443

Mailing address

7025 Beracasa Way
Ste 102B
Boca Raton, FL 33433-3428
Phone (561) 416-7338

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
I20090513000619 FL Practitioner - Clinical Psychologist 4284783671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7025 Beracasa Way
102B
Boca Raton, FL 33433-3413
Phone (561) 416-7338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5164FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Laquidara PHD PA Clinical CurrentSince Mar 21, 2009 Accepting new patients
Diane Abdo Psy D PA Clinical Past Accepting new patients

Locations

7025 Beracasa Way
Ste 102B
Boca Raton, FL 33433
Phone (561) 416-7338

Organizations & group practices 2

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1366496291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 BERACASA WAY",
            "address_2": "STE 102B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333428",
            "telephone_number": "561-416-7338",
            "fax_number": "561-416-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 BERACASA WAY",
            "address_2": "102 B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333443",
            "telephone_number": "561-416-7338",
            "fax_number": "561-416-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAQUIDARA",
        "first_name": "ELIZABETH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.