Provider Demographics
NPI:1346748472
Name:DIAZ-PARRILLA, LIZAMARIE (MS-SLP)
Entity Type:Individual
Prefix:MS
First Name:LIZAMARIE
Middle Name:
Last Name:DIAZ-PARRILLA
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11970 GENNARO LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7134
Mailing Address - Country:US
Mailing Address - Phone:787-436-0434
Mailing Address - Fax:
Practice Address - Street 1:11970 GENNARO LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7134
Practice Address - Country:US
Practice Address - Phone:787-436-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8419235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist