Healthcare Provider Details
I. General information
NPI: 1417508813
Provider Name (Legal Business Name): DEENA CILIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/26/2019
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13397 SW 131ST ST
MIAMI FL
33186-5816
US
IV. Provider business mailing address
7410 MIRAMAR BLVD
MIRAMAR FL
33023-4775
US
V. Phone/Fax
- Phone: 954-816-6309
- Fax:
- Phone: 954-816-6309
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: