Marlisis Licea I, MD

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

79776 Issued in FL

Practice address

10985 SW 107TH St Apt 202
Miami, FL 33176-3344

Phone

(786) 560-5824

Fax

(786) 560-5824

NPI assigned

Jul 23, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679096580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10985 SW 107TH ST APT 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763344",
            "telephone_number": "305-917-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10985 SW 107TH ST APT 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331763344",
            "telephone_number": "786-560-5824",
            "fax_number": "786-560-5824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10985 SW 107th St Apt 202",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331763344",
            "country_code": "US",
            "telephone_number": "786-560-5824",
            "fax_number": "786-560-5824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10985 SW 107th St Apt 202",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331763344",
            "country_code": "US",
            "telephone_number": "305-917-5986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICEA",
        "first_name": "MARLISIS",
        "name_suffix": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "FL",
            "license": "79776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Licea Hernandez
• Yumisleidy Y Licea Perez
• Dayamis Leisis Licea Verdecia, RBT
• Frank Alejandro Licea
• Irina Licea, MD
• Yadira Licea
• Theresa Lichtenberg, MD
• Paola N Lichtenberger, M.D.
• Marc Lichtenstein, P.T.
• Monte Lichtiger, MD

• Personal Care Attendant in Miami, FL
• Providers in Miami, FL by specialty
• Personal Care Attendant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.