Provider Demographics
NPI:1235932476
Name:ESTEVEZ, LIDIA LIZA
Entity type:Individual
Prefix:
First Name:LIDIA
Middle Name:LIZA
Last Name:ESTEVEZ
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 1:14455 SW 298TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-3939
Mailing Address - Country:US
Mailing Address - Phone:786-786-4304
Mailing Address - Fax:
Practice Address - Street 1:14455 SW 298TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3939
Practice Address - Country:US
Practice Address - Phone:786-786-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-414700106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician