Lourdes Lizardi, MD
Individual provider Active NPI General Practice Physician · Mayagues, PR
NPI 1376794933 · NPPES record last updated Oct 1, 2008
Key facts
- NPI
- 1376794933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 11178 (PR)
- Practice address
- C.F.S.E. Region de Mayaguez
Ave. Los Corazones
Mayagues, PR 00681 - Phone
- (787) 833-8700
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11178 | PR | MD | General Practice Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 11178 | PR | Yes |
Addresses
Primary practice location
C.F.S.E. Region de Mayaguez
Ave. Los Corazones
Mayagues, PR 00681
Mailing address
P.O.Box-250537
Aguadilla, PR 00604-0537
Phone (787) 252-8936
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11178 | Other | PR | LICENSIA MD |
Other providers in Mayagues, PR
All providers in Mayagues, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.