Provider Demographics
NPI:1235486812
Name:SIMOES, LIANE FERNANDES (BSW)
Entity Type:Individual
Prefix:MS
First Name:LIANE
Middle Name:FERNANDES
Last Name:SIMOES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 PENINSULA LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7472
Mailing Address - Country:US
Mailing Address - Phone:386-586-8514
Mailing Address - Fax:
Practice Address - Street 1:1060 PELICAN BAY DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-9700
Practice Address - Country:US
Practice Address - Phone:386-586-8514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator