Provider Demographics
NPI:1578707956
Name:MUNOZ, LIZBETTE MARIA (MS, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:LIZBETTE
Middle Name:MARIA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6320
Mailing Address - Country:US
Mailing Address - Phone:352-805-4404
Mailing Address - Fax:
Practice Address - Street 1:37 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:INGLIS
Practice Address - State:FL
Practice Address - Zip Code:34449-9521
Practice Address - Country:US
Practice Address - Phone:352-281-7787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16941235Z00000X
PASL009118235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA16941OtherSPEECH PATHOLOGIST LICENSE