Provider Demographics
NPI:1750719647
Name:LAGUARDIA, LIZ (MSN, ARNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LIZ
Middle Name:
Last Name:LAGUARDIA
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 W 57TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6826
Mailing Address - Country:US
Mailing Address - Phone:305-609-2475
Mailing Address - Fax:
Practice Address - Street 1:1714 W 57TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6826
Practice Address - Country:US
Practice Address - Phone:305-609-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9280565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily