Provider Demographics
NPI:1982681433
Name:BRIONES, LIAM ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:LIAM
Middle Name:ALEXANDER
Last Name:BRIONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BERTA
Other - Middle Name:MARIA
Other - Last Name:BRIONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12700 LAKE AVE APT 3006
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1590
Mailing Address - Country:US
Mailing Address - Phone:216-544-8680
Mailing Address - Fax:216-274-9631
Practice Address - Street 1:600 SUPERIOR AVE E STE 1300
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2654
Practice Address - Country:US
Practice Address - Phone:216-544-8680
Practice Address - Fax:216-274-9631
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3565109207RP1001X
CA55540207RS0012X
FL104297207RP1001X
AZ42786207RP1001X
OH35065109207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0176778Medicaid
OH0176778Medicaid
OHG17130Medicare UPIN