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Organization
L. MARISCAL, M.D., PA
Active
Organization
L. MARISCAL, M.D., PA
Active
Other names
MARISCAL PEDIATRICS AND FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LIUSKA MARISCAL MD (OWNER)
(786) 703-8174
Entity
Organization
Contact information
Practice address
12991 SW 112TH ST, MIAMI, FL 33186-4769
(786) 298-3854
Mailing address
12991 SW 112TH ST, MIAMI, FL 33186-4769
(786) 703-8174
(786) 703-8190
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
ME 95687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127271635
—
FL
Enumeration date
05/13/2014
Last updated
01/14/2023
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