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NPI Code Detail

MEDICARE: LYANA MARIA ISSA

MEDICARE: LYANA MARIA ISSA
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
1363LF0000XFamily Nurse Practitioner9409793FL

Other Identifiers

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

General Provider Information

NPI Number : 1982101135
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYANA MARIA ISSA
Provider Business Mailing Address
First Line : 5710 COACH HOUSE CIR APT E
Second Line :
City : BOCA RATON
State : FL
Zip : 33486-8692
Country : US
Telephone Number : 561-213-0801
Fax Number :
Provider Business Practice Location Address
First Line : 8954 LANTANA RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33467-6112
Country : US
Telephone Number : 561-213-0801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2018
Last Update Date : 03/11/2021

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Directions to “ LYANA MARIA ISSA ” Practice Location

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