Provider Demographics
NPI:1467402354
Name:LIZARDI RAMIREZ, LUIS ANTONIO (RPT, DPT, ATRIC)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ANTONIO
Last Name:LIZARDI RAMIREZ
Suffix:
Gender:M
Credentials:RPT, DPT, ATRIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135-9 CALLE 401
Mailing Address - Street 2:VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-4006
Mailing Address - Country:US
Mailing Address - Phone:787-449-6462
Mailing Address - Fax:787-294-9862
Practice Address - Street 1:135-9 CALLE 401
Practice Address - Street 2:4TA EXT. VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-449-6462
Practice Address - Fax:787-294-9862
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11252251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0068185Medicare PIN
PRQ11476Medicare UPIN
PR0057981AMedicare PIN