Provider Demographics
NPI:1093368268
Name:ABELLEIRA, LIANETH
Entity Type:Individual
Prefix:
First Name:LIANETH
Middle Name:
Last Name:ABELLEIRA
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 1:677 SW 9TH AVE APT 311
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3276
Mailing Address - Country:US
Mailing Address - Phone:786-444-9995
Mailing Address - Fax:
Practice Address - Street 1:677 SW 9TH AVE APT 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3276
Practice Address - Country:US
Practice Address - Phone:786-444-9995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-59223106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician