Healthcare Provider Details

I. General information

NPI: 1851392237
Provider Name (Legal Business Name): VIRGINIA PITTS LILIENTHAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13475 SOUTHERN BLVD STE 202
LOXAHATCHEE GROVES FL
33470-9233
US

IV. Provider business mailing address

2000 PALM BEACH LAKES BLVD STE 901
WEST PALM BEACH FL
33409-6506
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-2468
  • Fax: 561-798-2733
Mailing address:
  • Phone: 561-509-5009
  • Fax: 561-738-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME105916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: