MR. JOSE LUIS LIZARDI (PA-C) – Physician Assistant, NPI 1710959622
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. JOSE LUIS LIZARDI (PA-C)
306 HOLLINGSHEAD LOOP
DAVENPORT, FL 338967829
Phone: (863) 420-7787
Type: Location
931 W Oak St Ste 103
Kissimmee, FL 347414973
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
1115 N John Young Pkwy
Kissimmee, FL 347414209
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
900 Towne Center Dr
Kissimmee, FL 347593470
Phone: (407) 931-0444
Type: Location
5425 S Semoran Blvd
Orlando, FL 328221748
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
6210 W Colonial Dr Ste 100
Orlando, FL 328087504
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
3130 Citrus Tower Blvd
Clermont, FL 347116801
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
5249 Conway Rd
Orlando, FL 328122202
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
2685 SW 32nd Pl Ste 100
Ocala, FL 344717863
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
PO BOX 44008
UFJP WINTER HAVEN
JACKSONVILLE, FL 322314008
Phone: (904) 244-3199
Fax: (904) 244-3425
Type: Mailing
2330 NORTH BLVD W
DAVENPORT, FL 338378989
Phone: (407) 931-0444
Fax: (407) 962-4446
Type: Location
900 TOWNE CENTER DR
KISSIMMEE, FL 347593470
Phone: (407) 931-0444
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $88.
Total Amount is formed as General ($88) + Research ($0) + Ownership ($0) = $88.
Last reported payment date: 2024-07-16 • Largest payer in this snapshot: Aadi Bioscience, Inc. ($88).
Total Amount
$88
General + Research + Ownership
Payments
1
Total payment records
General Amount
$88
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Aadi Bioscience, Inc. | $88 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-04-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040413001821 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33896)
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Reviews
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