Provider Demographics
NPI:1679145577
Name:TAMAYO FLORES, LIENA A (APRN)
Entity Type:Individual
Prefix:
First Name:LIENA
Middle Name:A
Last Name:TAMAYO FLORES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13763 SW 157TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1261
Mailing Address - Country:US
Mailing Address - Phone:786-222-2907
Mailing Address - Fax:
Practice Address - Street 1:13763 SW 157TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1261
Practice Address - Country:US
Practice Address - Phone:786-222-2907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily