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General NPI Number Information
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NPI Number | 1255575866
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Entity Type | Organization
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Legal Business Name | VILLA LYAN, INC.
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 18950 SW 106TH AVE SUITE 119
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 786-206-3928
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Fax | 786-724-1404
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Provider Business Mailing Address
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Address Line | 18950 SW 106 AVE SUITE 119
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 786-206-3928
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Fax | 786-724-1404
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO L MENENDEZ
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Credential |
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Telephone | 786-206-3928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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