Provider Demographics
NPI:1538295431
Name:AQUINO ROBLES, LIANI M (MD)
Entity Type:Individual
Prefix:DR
First Name:LIANI
Middle Name:M
Last Name:AQUINO ROBLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-447-7105
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:1050 CYPRESS PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3328
Practice Address - Country:US
Practice Address - Phone:407-348-8338
Practice Address - Fax:407-348-1709
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16700208D00000X
FLACN857208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN857OtherMEDICAL LICENSE NUMBER
FL020781800Medicaid
FLIX018XOtherMEDICARE