Provider Demographics
NPI:1023845781
Name:PRIETO ARMAS, LILIEN (PA)
Entity type:Individual
Prefix:MS
First Name:LILIEN
Middle Name:
Last Name:PRIETO ARMAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 ROYCE RD
Mailing Address - Street 2:
Mailing Address - City:LABELLE
Mailing Address - State:FL
Mailing Address - Zip Code:33935-4586
Mailing Address - Country:US
Mailing Address - Phone:786-416-2411
Mailing Address - Fax:
Practice Address - Street 1:634 ROYCE RD
Practice Address - Street 2:
Practice Address - City:LABELLE
Practice Address - State:FL
Practice Address - Zip Code:33935-4586
Practice Address - Country:US
Practice Address - Phone:786-416-2411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001130363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant