Healthcare Provider Details

I. General information

NPI: 1679213995
Provider Name (Legal Business Name): LEDYS LILIANA MELGAREJO SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9380 SW 72ND ST STE B224
MIAMI FL
33173-5460
US

IV. Provider business mailing address

2114 N FLAMINGO RD # 2412
PEMBROKE PINES FL
33028-3501
US

V. Phone/Fax

Practice location:
  • Phone: 786-597-1214
  • Fax:
Mailing address:
  • Phone: 786-597-1214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: