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General NPI Number Information
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NPI Number | 1548078991
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Entity Type | Individual
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Provider Name | LILIANY MARIE NEAVES BETANCES
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Gender | Female
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1735 CARR 844
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City | SAN JUAN
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State | PR
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Zip | 00926-4446
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Country | US
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Telephone | 787-647-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 617 CALLE FRANCISCO CASALDUC
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City | SAN JUAN
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State | PR
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Zip | 00924-2115
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Country | US
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Telephone | 787-949-4902
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2639-1
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License Number State | PR
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