Provider Demographics
NPI:1083169486
Name:ALFONSO TUR, LILIANA CECILIA
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:CECILIA
Last Name:ALFONSO TUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4246 NW 2ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5421
Mailing Address - Country:US
Mailing Address - Phone:786-306-7042
Mailing Address - Fax:
Practice Address - Street 1:4246 NW 2ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5421
Practice Address - Country:US
Practice Address - Phone:786-306-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty