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NPI Code Detail

MEDICARE: LIANIS PENA ZAMORA

MEDICARE:   LIANIS  PENA ZAMORA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1790544781
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIANIS PENA ZAMORA
Provider Business Mailing Address
First Line : 1216 DUNNDALE ST
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-4816
Country : US
Telephone Number : 239-544-6572
Fax Number :
Provider Business Practice Location Address
First Line : 1216 DUNNDALE ST
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33936-4816
Country : US
Telephone Number : 239-544-6572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2024
Last Update Date : 06/26/2025

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Directions to “ LIANIS PENA ZAMORA ” Practice Location

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