Provider Demographics
NPI:1336934058
Name:MORALES IZQUIERDO, LIZ DE FATIMA
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:DE FATIMA
Last Name:MORALES IZQUIERDO
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 1:1165 NW 135TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2615
Mailing Address - Country:US
Mailing Address - Phone:786-925-1929
Mailing Address - Fax:
Practice Address - Street 1:1165 NW 135TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-2615
Practice Address - Country:US
Practice Address - Phone:786-925-1929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician