Provider Demographics
NPI:1679139349
Name:SAINZ, LILIANA
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:SAINZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YOLEXIS
Other - Middle Name:
Other - Last Name:FUENTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12210 SW 130TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6217
Mailing Address - Country:US
Mailing Address - Phone:786-634-8659
Mailing Address - Fax:
Practice Address - Street 1:12210 SW 130TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6217
Practice Address - Country:US
Practice Address - Phone:786-634-8659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver