Provider Demographics
NPI:1508146655
Name:GOMEZ, LILIANA (AP)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13931 MONTICELLO ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-1263
Mailing Address - Country:US
Mailing Address - Phone:954-678-8457
Mailing Address - Fax:
Practice Address - Street 1:1500 WESTON RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3265
Practice Address - Country:US
Practice Address - Phone:954-793-9383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-21
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2882171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist