Healthcare Provider Details

I. General information

NPI: 1093037103
Provider Name (Legal Business Name): JANETTE MAGARINO-LIRIANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 103
CELEBRATION FL
34747-5432
US

IV. Provider business mailing address

410 CELEBRATION PL STE 103
CELEBRATION FL
34747-5432
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4655
  • Fax: 407-303-4654
Mailing address:
  • Phone: 407-303-4655
  • Fax: 407-303-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME107590
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME107590
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: