Provider Demographics
NPI:1477096527
Name:LIZARDO ORBE, EDWINA ODETTE
Entity type:Individual
Prefix:
First Name:EDWINA
Middle Name:ODETTE
Last Name:LIZARDO ORBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EDWINA
Other - Middle Name:
Other - Last Name:ADRIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1210 POPLAR FOREST LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5181
Mailing Address - Country:US
Mailing Address - Phone:917-647-6750
Mailing Address - Fax:
Practice Address - Street 1:1210 POPLAR FOREST LN
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5181
Practice Address - Country:US
Practice Address - Phone:917-647-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62 021026225100000X
NCP23987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist