Individual
LISSETTE D CORTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3661 S MIAMI AVE STE 402, MIAMI, FL 33133-4230
(305) 815-0055
(347) 493-3512
Mailing address
1250 ASTURIA AVE, CORAL GABLES, FL 33134-4736
(786) 205-4066
(347) 493-3512
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME129982
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019445200
—
FL
Enumeration date
02/25/2011
Last updated
04/16/2019
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