Individual
MARLISIS LICEA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10985 SW 107TH ST APT 202, MIAMI, FL 33176-3344
(786) 560-5824
(786) 560-5824
Mailing address
10985 SW 107TH ST APT 202, MIAMI, FL 33176-3344
(305) 917-5986
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
79776
FL
Other
Enumeration date
07/23/2017
Last updated
07/21/2022
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