Provider Demographics
NPI:1285713883
Name:OLIVA VILLAR, LIZETT (MS, SLP)
Entity type:Individual
Prefix:
First Name:LIZETT
Middle Name:
Last Name:OLIVA VILLAR
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 W 60TH ST
Mailing Address - Street 2:APT. 111A
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4057
Mailing Address - Country:US
Mailing Address - Phone:305-362-8509
Mailing Address - Fax:
Practice Address - Street 1:10794 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2499
Practice Address - Country:US
Practice Address - Phone:786-237-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-19-36932103K00000X
FLSA16706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst