Individual provider Active NPI

Lynda Rose Colaizzi

  • Dentist
  • Coral Gables, FL
National Provider Identifier
1710153374
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11046 Issued in FL
Practice address
645 Minorca Ave
Coral Gables, FL 33134-3756
Phone
(305) 790-3361
NPI assigned
May 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11046 FL Primary

Addresses

Primary practice location

645 Minorca Ave
Coral Gables, FL 33134-3756

Mailing address

645 Minorca Ave
Coral Gables, FL 33134-3756
Phone (305) 790-3361

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151027001737 FL Order and Referring Only - DentistPractitioner - Dentist 5991014227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN11046FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1710153374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 MINORCA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331343756",
            "telephone_number": "305-790-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 MINORCA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331343756",
            "telephone_number": "305-790-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLAIZZI",
        "first_name": "LYNDA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.