MEDICARE: DR. LISA SAPONARO PH.D.

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	103T00000X	Psychologist	PY7494	FL
2	103TB0200X	Cognitive & Behavioral Psychologist
3	103TC1900X	Counseling Psychologist
4	103TC2200X	Clinical Child & Adolescent Psychologist
5	103TF0000X	Family Psychologist
6	103TP2701X	Group Psychotherapy Psychologist
7	103TC0700X	Clinical Psychologist	PY7494	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750594602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA SAPONARO PH.D.

Provider Business Mailing Address
First Line	:	1469 NW 129TH WAY
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2984
Country	:	US
Telephone Number	:	954-560-9567
Fax Number	:	954-423-0901

Provider Business Practice Location Address
First Line	:	7820 PETERS RD STE E100
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-4019
Country	:	US
Telephone Number	:	954-577-0095
Fax Number	:	954-423-0901

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	02/17/2025

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