Provider Demographics
NPI:1972532885
Name:DEBORJA, LILIA LOFRANCO (MD)
Entity Type:Individual
Prefix:DR
First Name:LILIA
Middle Name:LOFRANCO
Last Name:DEBORJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4200 EDMONDSON AVENUE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229
Mailing Address - Country:US
Mailing Address - Phone:410-624-0037
Mailing Address - Fax:410-947-2794
Practice Address - Street 1:4200 EDMONDSON AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229
Practice Address - Country:US
Practice Address - Phone:410-624-0037
Practice Address - Fax:410-947-2794
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD16970208000000X
MDD0016970208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD006811001Medicaid