Provider Demographics
NPI:1659937092
Name:PERINAN, LILIANA MILENA
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:MILENA
Last Name:PERINAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 W 81ST ST APT 104
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4142
Mailing Address - Country:US
Mailing Address - Phone:561-614-9488
Mailing Address - Fax:
Practice Address - Street 1:666 W 81ST ST APT 104
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4142
Practice Address - Country:US
Practice Address - Phone:561-614-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA17196224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty