Healthcare Provider Details

I. General information

NPI: 1750801767
Provider Name (Legal Business Name): NELIA LIEN VIERA SAUCO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4302 E 10TH AVE
HIALEAH FL
33013-2514
US

IV. Provider business mailing address

15639 SW 73RD CIRCLE TER APT 76
MIAMI FL
33193-1841
US

V. Phone/Fax

Practice location:
  • Phone: 786-212-1008
  • Fax: 786-334-5826
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number45447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: