Provider Demographics
NPI:1619861507
Name:VICTOR, LIDIA
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:
Last Name:VICTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7638 MEED CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2517
Mailing Address - Country:US
Mailing Address - Phone:561-707-8999
Mailing Address - Fax:561-707-8999
Practice Address - Street 1:901 NORTHPOINT PKWY STE 400
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1954
Practice Address - Country:US
Practice Address - Phone:561-729-6143
Practice Address - Fax:561-516-8200
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)