Provider Demographics
NPI:1689432973
Name:PASCUAL GONZALEZ, LILY T
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:T
Last Name:PASCUAL GONZALEZ
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 1:8940 SW 5TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2333
Mailing Address - Country:US
Mailing Address - Phone:786-945-7001
Mailing Address - Fax:
Practice Address - Street 1:8940 SW 5TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2333
Practice Address - Country:US
Practice Address - Phone:786-945-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide