Provider Demographics
NPI:1568499689
Name:CARBON, LILIANA MARIA (CRNA)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:MARIA
Last Name:CARBON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 COLLINS AVE
Mailing Address - Street 2:APT 1202
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2700
Mailing Address - Country:US
Mailing Address - Phone:786-479-3415
Mailing Address - Fax:
Practice Address - Street 1:5025 COLLINS AVE
Practice Address - Street 2:APT 1202
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2700
Practice Address - Country:US
Practice Address - Phone:786-479-3415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9165281367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306227900Medicaid
FLG3489ZMedicare ID - Type Unspecified