Individual provider Active NPI

Lizmar Vega Ross, MD

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1831755677
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1346 Issued in FL
Practice address
6726 Hanley Rd
Tampa, FL 33634-4739
Phone
(813) 284-7903
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 21764 PR
General Practice Physician 208D00000X 1346 FL Primary

Addresses

Primary practice location

6726 Hanley Rd
Tampa, FL 33634-4739

Mailing address

6726 Hanley Rd
Tampa, FL 33634-4739
Phone (813) 284-7903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1346FLMDGeneral Practice Physician
21764PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1831755677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6726 HANLEY RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336344739",
            "telephone_number": "813-284-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6726 HANLEY RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336344739",
            "telephone_number": "813-284-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA ROSS",
        "first_name": "LIZMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "21764",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "1346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.