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General NPI Number Information
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NPI Number | 1245169036
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Entity Type | Individual
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Provider Name | LILIANA PRATA SOUZA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2026
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Last Update Date | 05/18/2026
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Provider Practice Location Address
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Address Line | MARECHAL CAMPOS AV, 1355 SANTA CECILIA
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City | VITORIA
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State | ES
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Zip | 29043260
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Country | BR
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | EARIJOS, 61 APT 301, JARDIM DA PENHA
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City | VITORIA
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State | ES
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Zip | 29060700
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Country | BR
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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