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General NPI Number Information
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NPI Number | 1598059263
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Entity Type | Individual
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Provider Name | LIDELIS D LIRA AP & LMT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2011
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Last Update Date | 06/06/2020
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Provider Practice Location Address
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Address Line | 11301 S ORANGE BLOSSOM TRL STE A208
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City | ORLANDO
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State | FL
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Zip | 32837-9292
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Country | US
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Telephone | 407-751-2192
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Fax | 407-542-2243
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Provider Business Mailing Address
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Address Line | 14712 SW 5TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6113
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Country | US
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Telephone | 786-352-3844
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA47503
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3334
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License Number State | FL
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