Provider Demographics
NPI:1497764419
Name:ESTRIN, LILI (MD)
Entity Type:Individual
Prefix:
First Name:LILI
Middle Name:
Last Name:ESTRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850001
Mailing Address - Street 2:DEPARTMENT 980
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0980
Mailing Address - Country:US
Mailing Address - Phone:305-532-4051
Mailing Address - Fax:305-538-0655
Practice Address - Street 1:400 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-532-4051
Practice Address - Fax:305-538-0655
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062960207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005591OtherNEIGHBORHOOD HEALTH
FL102510OtherAVMED
FL18044OtherBLUE CROSS BLUE SHIELD
FL15557OtherAETNA
FL8497600OtherJMH
FL376923200Medicaid
FLF38890Medicare UPIN
FL18044Medicare PIN