MEDICARE: LILIANA PELAYO FMD/CBHCM/BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1740439421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIANA PELAYO FMD/CBHCM/BSN

Provider Business Mailing Address
First Line	:	2301 SW 27TH AVE APT 706
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33145-3672
Country	:	US
Telephone Number	:	786-414-5921
Fax Number	:

Provider Business Practice Location Address
First Line	:	12001 SW 128TH CT STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-4665
Country	:	US
Telephone Number	:	786-975-7485
Fax Number	:	954-860-7166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	05/18/2022

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Directions to “ LILIANA PELAYO FMD/CBHCM/BSN” Practice Location

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