Active NPI
Santiago Lizarazo, M.D.
- Pediatrics Physician
- Homestead, FL
National Provider Identifier
1740500800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C54073
- Practice address
- 3084 NE 41St Ter
Homestead, FL 33033-6619 - Phone
- (305) 245-8050
- Fax
- (305) 245-5950
- NPI assigned
- Jun 10, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C54073 | CA | Primary |
Addresses
Primary practice location
3084 NE 41St Ter
Homestead, FL 33033-6619
Mailing address
900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (954) 967-6400
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023391800 | Medicaid | FL | |
| C54073 | Other | CA | LICENSE |
| ME77787 | Other | FL | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C54073 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson | Pediatrics | Past | Accepting new patients |
| Saltzman, Tanis, Pittell, Levin and Jacobson, LLC | Pediatrics | Past | Accepting new patients |
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.
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
-
- Pediatrics Physician
- Homestead, FL
- NPI 1265789226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1740500800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S PINE ISLAND RD STE 800",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243923",
"telephone_number": "954-967-6400",
"fax_number": "954-965-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3084 NE 41ST TER",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330336619",
"telephone_number": "305-245-8050",
"fax_number": "305-245-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIZARAZO",
"first_name": "SANTIAGO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-10",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C54073",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023391800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "C54073",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "ME77787",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.