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General NPI Number Information
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NPI Number | 1891131769
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Entity Type | Individual
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Provider Name | LILIANA RINCON ALZATE M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1901 PHOENIX BLVD
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City | ATLANTA
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State | GA
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Zip | 30349-5063
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Country | US
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Telephone | 800-994-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 VIRGINIA WAY STE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-7542
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Country | US
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Telephone | 615-221-4400
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | R6661
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 102664
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License Number State | GA
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