Provider Demographics
NPI:1215256649
Name:MOJICA, LYSENIA (MD)
Entity type:Individual
Prefix:
First Name:LYSENIA
Middle Name:
Last Name:MOJICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYSENIA
Other - Middle Name:
Other - Last Name:MOJICA-FIGUEROA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4729 N HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7113
Mailing Address - Country:US
Mailing Address - Phone:813-251-8444
Mailing Address - Fax:813-254-6414
Practice Address - Street 1:4729 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7113
Practice Address - Country:US
Practice Address - Phone:813-251-8444
Practice Address - Fax:813-254-6414
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program