Provider Demographics
NPI:1770144206
Name:CASANAS IZQUIERDO, LIZ C (MS CFSLP)
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:C
Last Name:CASANAS IZQUIERDO
Suffix:
Gender:F
Credentials:MS CFSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 SW 102ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2737
Mailing Address - Country:US
Mailing Address - Phone:305-978-0211
Mailing Address - Fax:
Practice Address - Street 1:1114 SW 102ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2737
Practice Address - Country:US
Practice Address - Phone:305-978-0211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist