Healthcare Provider Details

I. General information

NPI: 1366370512
Provider Name (Legal Business Name): LILIAN CRISTINA ROTARESCU REZENDE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 S FEDERAL HWY STE 100
DEERFIELD BEACH FL
33441-7000
US

IV. Provider business mailing address

10321 LEXINGTON LAKES BLVD S
BOYNTON BEACH FL
33436-4550
US

V. Phone/Fax

Practice location:
  • Phone: 954-943-9670
  • Fax:
Mailing address:
  • Phone: 954-415-2508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003098
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: