Provider Demographics
NPI:1265864417
Name:PRELLEZO, LILY BEATRIZ
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:BEATRIZ
Last Name:PRELLEZO
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 1:594 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7615
Mailing Address - Country:US
Mailing Address - Phone:954-344-6550
Mailing Address - Fax:954-344-8634
Practice Address - Street 1:594 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7615
Practice Address - Country:US
Practice Address - Phone:954-344-6550
Practice Address - Fax:954-344-8634
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst