Healthcare Provider Details

I. General information

NPI: 1326107954
Provider Name (Legal Business Name): LILIA PRADO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILIA PRADO-GOBER

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 LOMITA BLVD STE 101
HARBOR CITY CA
90710-2084
US

IV. Provider business mailing address

6101 BLUE LAGOON DR STE 200
MIAMI FL
33126-3168
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO2678
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A5538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: