Provider Demographics
NPI:1548249329
Name:LIRANZO, MARITZA O (MD)
Entity type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:O
Last Name:LIRANZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:214-932-8029
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:745 ORIENTA AVE
Practice Address - Street 2:SUITE 1201
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5619
Practice Address - Country:US
Practice Address - Phone:800-226-8968
Practice Address - Fax:407-856-2312
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME68000207ZP0102X, 207ZD0900X
CO32055207ZD0900X
GA65369207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06088ZMedicare PIN
FLF88816Medicare UPIN
FL06088YMedicare PIN