Provider Demographics
NPI:1396572889
Name:MILAN, LIENNIS B
Entity type:Individual
Prefix:
First Name:LIENNIS
Middle Name:B
Last Name:MILAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 SW 138TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7172
Mailing Address - Country:US
Mailing Address - Phone:832-891-5957
Mailing Address - Fax:
Practice Address - Street 1:9001 SW 138TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7172
Practice Address - Country:US
Practice Address - Phone:832-891-5957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician