Provider Demographics
NPI:1629888797
Name:RAMOS RIOS, LILLIANETTE (APRN)
Entity type:Individual
Prefix:
First Name:LILLIANETTE
Middle Name:
Last Name:RAMOS RIOS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2462 CASPIAN DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-2690
Mailing Address - Country:US
Mailing Address - Phone:813-378-2044
Mailing Address - Fax:
Practice Address - Street 1:391 HAVENDALE BLVD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-4536
Practice Address - Country:US
Practice Address - Phone:863-213-7160
Practice Address - Fax:863-583-0451
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036809363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily