Provider Demographics
NPI:1639978828
Name:TAPANES, LIZ D
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:D
Last Name:TAPANES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26150 SW 137TH AVE # APP308
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6984
Mailing Address - Country:US
Mailing Address - Phone:786-407-9345
Mailing Address - Fax:
Practice Address - Street 1:26150 SW 137TH AVE # APP308
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-6984
Practice Address - Country:US
Practice Address - Phone:786-407-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-413347106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician