Provider Demographics
NPI:1831495084
Name:PANIAGUA, LILI (OTR)
Entity Type:Individual
Prefix:MS
First Name:LILI
Middle Name:
Last Name:PANIAGUA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10822 SW 146TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6601
Mailing Address - Country:US
Mailing Address - Phone:786-362-9811
Mailing Address - Fax:
Practice Address - Street 1:9010 SW 137TH AVE
Practice Address - Street 2:SUITE 242
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1413
Practice Address - Country:US
Practice Address - Phone:305-388-0004
Practice Address - Fax:305-388-8009
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 14410225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist