=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639047541
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIANA MARIE LEJA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2025
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 927 45TH STREET, STE 204
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33407-2413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-844-5255
-----------------------------------------------------
Fax | 561-844-5245
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 20802
-----------------------------------------------------
City | BELFAST
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04915-4105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-402-7256
-----------------------------------------------------
Fax | 888-902-1099
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN11042701
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------