Provider Demographics
NPI:1326286576
Name:LILIAV, BENJAMIN B (MD)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:B
Last Name:LILIAV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2401 S OCEAN DR APT 2703
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2672
Mailing Address - Country:US
Mailing Address - Phone:305-741-3870
Mailing Address - Fax:
Practice Address - Street 1:825 BRICKELL BAY DR STE 1845
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2920
Practice Address - Country:US
Practice Address - Phone:305-456-3666
Practice Address - Fax:207-973-6966
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 390200000X
FLME138619208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program