MEDICARE: LIRA HEALTH CLINIC LLC

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	261QH0100X	Health Service Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1437007978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIRA HEALTH CLINIC LLC

Provider Business Mailing Address
First Line	:	4401 VINELAND RD STE A13
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-7215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 VINELAND RD STE A13
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32811-7215
Country	:	US
Telephone Number	:	689-332-7801
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELAINE DE CARVALHO MACEDO
Credential	:	NP
Telephone Number	:	786-710-7895

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	05/02/2026

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