Provider Demographics
NPI:1861146359
Name:ESPINAR PEREZ, LISBET
Entity type:Individual
Prefix:
First Name:LISBET
Middle Name:
Last Name:ESPINAR PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7364 SW 82ND ST APT E212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7433
Mailing Address - Country:US
Mailing Address - Phone:786-705-9046
Mailing Address - Fax:
Practice Address - Street 1:10700 SW 108TH AVE APT C312
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8645
Practice Address - Country:US
Practice Address - Phone:786-705-9046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-310083106S00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician