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Organization

VILLA LYAN, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTONIO L MENENDEZ (PRESIDENT)
(786) 206-3928
Entity
Organization

Contact information

Practice address
18950 SW 106TH AVE, SUITE 119, MIAMI, FL 33157
(786) 206-3928
(786) 724-1404
Mailing address
18950 SW 106 AVE, SUITE 119, MIAMI, FL 33157
(786) 206-3928
(786) 724-1404

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
224Z00000X
Occupational Therapy Assistant
2251P0200X
Pediatric Physical Therapist
225200000X
Physical Therapy Assistant
225700000X
Massage Therapist
225A00000X
Music Therapist
225XP0200X
Pediatric Occupational Therapist
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
012176200
FL
Enumeration date
04/27/2009
Last updated
12/20/2021
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