Provider Demographics
NPI:1861460024
Name:DEFIORE, LILIANA P (RPT)
Entity Type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:P
Last Name:DEFIORE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4968 ROYAL GULF CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-7006
Mailing Address - Country:US
Mailing Address - Phone:239-275-4411
Mailing Address - Fax:239-275-6408
Practice Address - Street 1:4968 ROYAL GULF CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-7006
Practice Address - Country:US
Practice Address - Phone:239-275-4411
Practice Address - Fax:239-275-6408
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY1303Medicare ID - Type UnspecifiedMEDICARE