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NPI Code Detail

MEDICARE: LILLIANNE DO

MEDICARE:   LILLIANNE  DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS026804AZ

General Provider Information

NPI Number : 1225807415
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIANNE DO
Provider Business Mailing Address
First Line : 2220 E BEARDSLEY RD APT 1022
Second Line :
City : PHOENIX
State : AZ
Zip : 85024-3404
Country : US
Telephone Number : 714-657-9834
Fax Number :
Provider Business Practice Location Address
First Line : 20040 N 19TH AVE STE A
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-4256
Country : US
Telephone Number : 623-869-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2023
Last Update Date : 01/05/2024

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Directions to “ LILLIANNE DO ” Practice Location

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