Healthcare Provider Details

I. General information

NPI: 1134929110
Provider Name (Legal Business Name): MRS. LIVIA ALIUSKA LLUIS FLEITAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SE 10TH AVE # E2
POMPANO BEACH FL
33060-7333
US

IV. Provider business mailing address

301 SE 10TH AVE # E2
POMPANO BEACH FL
33060-7333
US

V. Phone/Fax

Practice location:
  • Phone: 239-350-8663
  • Fax: 786-907-4972
Mailing address:
  • Phone: 239-350-8663
  • Fax: 786-907-4972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-417117
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: