Provider Demographics
NPI:1275837700
Name:LEMUS, MARILYS
Entity Type:Individual
Prefix:MS
First Name:MARILYS
Middle Name:
Last Name:LEMUS
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 1:10550 W STATE ROAD 84 LOT 162
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4211
Mailing Address - Country:US
Mailing Address - Phone:305-742-9705
Mailing Address - Fax:
Practice Address - Street 1:12555 ORANGE DR STE 222
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4304
Practice Address - Country:US
Practice Address - Phone:954-862-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant