Provider Demographics
NPI:1699024265
Name:MUCI, LISETT (BA)
Entity Type:Individual
Prefix:
First Name:LISETT
Middle Name:
Last Name:MUCI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:LISETT
Other - Middle Name:
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1120 NW 14 STREET #1210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1628
Mailing Address - Country:US
Mailing Address - Phone:786-303-2924
Mailing Address - Fax:305-243-3501
Practice Address - Street 1:155 S MIAMI AVE STE 700
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1628
Practice Address - Country:US
Practice Address - Phone:786-218-4329
Practice Address - Fax:305-779-9601
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker