Individual
LISBETH STEPHANY SANTIAGO MERCEDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5229 WOOD THRUSH WAY, LAKELAND, FL 33811-1877
(787) 610-8067
Mailing address
5229 WOOD THRUSH WAY, LAKELAND, FL 33811-1877
(787) 610-8067
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
2124
PR
133V00000X
Registered Dietitian
Primary
14443
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14443
LICENSE
FL
01
—
2124
LICENSE
PR
Enumeration date
03/31/2020
Last updated
08/01/2025
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