Provider Demographics
NPI:1790127447
Name:MUNIZ, LIZANDRA (PSYD)
Entity type:Individual
Prefix:
First Name:LIZANDRA
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4079 NW 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6918
Mailing Address - Country:US
Mailing Address - Phone:786-368-5283
Mailing Address - Fax:
Practice Address - Street 1:4079 NW 66TH AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6918
Practice Address - Country:US
Practice Address - Phone:786-368-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14769101YM0800X
FLPY12360103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health