Provider Demographics
NPI:1578564993
Name:SAAVEDRA, LILLIAN T (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:T
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LILLIAN
Other - Middle Name:T
Other - Last Name:SAAVEDRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9818 MOHRS COVE LN
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8009
Mailing Address - Country:US
Mailing Address - Phone:407-592-3896
Mailing Address - Fax:
Practice Address - Street 1:7300 SANDLAKE COMMONS BLVD STE 315
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8011
Practice Address - Country:US
Practice Address - Phone:407-849-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 456932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043151600Medicaid
D55151Medicare UPIN
FL47705Medicare ID - Type Unspecified