Individual provider Active NPI

Lisa Maria Ruiz-Vangelatos, LCSW

  • Clinical Social Worker
  • Coral Gables, FL
National Provider Identifier
1871730549
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9211 Issued in FL
Practice address
3850 W Flagler St
Coral Gables, FL 33134-1604
Phone
(305) 774-3334
Fax
(305) 475-2650
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW9211 FL Primary

Addresses

Primary practice location

3850 W Flagler St
Coral Gables, FL 33134-1604

Mailing address

11031 NE 6TH Ave
Miami, FL 33161-7182
Phone (305) 398-6100

Other identifiers 1

IdentifierTypeStateIssuer
000894000MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
SW9211FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1871730549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 NE 6TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331617182",
            "telephone_number": "305-398-6100",
            "fax_number": "305-757-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 W FLAGLER ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341604",
            "telephone_number": "305-774-3334",
            "fax_number": "305-475-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ-VANGELATOS",
        "first_name": "LISA",
        "middle_name": "MARIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000894000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.