Individual
MS. JUDITH ANN LILJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6931 W SUNRISE BLVD, PLANTATION, FL 33313-4406
(954) 583-6200
Mailing address
2112 S CYPRESS BEND DR, APT 102, POMPANO BEACH, FL 33069-4452
(954) 972-1087
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3196012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00011953
RR MEDICARE
FL
01
—
P00011954
RR MEDICARE
FL
01
—
Y028H
BLUE SHIELD
FL
Enumeration date
08/01/2006
Last updated
07/08/2007
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