Provider Demographics
NPI:1376913145
Name:SOIVILIEN, LISEMONA (RRT)
Entity Type:Individual
Prefix:
First Name:LISEMONA
Middle Name:
Last Name:SOIVILIEN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRE POINTE BLVD APT 160
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4896
Mailing Address - Country:US
Mailing Address - Phone:850-339-0524
Mailing Address - Fax:
Practice Address - Street 1:1900 CENTRE POINTE BLVD APT 160
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4896
Practice Address - Country:US
Practice Address - Phone:850-339-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT12781227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered