MEDICARE: LISANDRA DE LA CRUZ CURBELO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	17743-I	PR

General Provider Information

NPI Number	:	1083549984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISANDRA DE LA CRUZ CURBELO MD

Provider Business Mailing Address
First Line	:	4719 SW 144TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-8904
Country	:	US
Telephone Number	:	786-260-7328
Fax Number	:

Provider Business Practice Location Address
First Line	:	1462 CALLE PROF AUGUSTO RODRIGUEZ
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909-2199
Country	:	US
Telephone Number	:	787-641-1616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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