Provider Demographics
NPI:1265126353
Name:SANTAMARIA, LIZETH (NBC-HWC)
Entity type:Individual
Prefix:MS
First Name:LIZETH
Middle Name:
Last Name:SANTAMARIA
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10115 HARTFORD MAROON RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6943
Mailing Address - Country:US
Mailing Address - Phone:407-900-8978
Mailing Address - Fax:
Practice Address - Street 1:10115 HARTFORD MAROON RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-6943
Practice Address - Country:US
Practice Address - Phone:407-900-8978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA-3489058171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach