Provider Demographics
NPI:1043897739
Name:CAMILLERI PERALTA, LIANYS DELMIS
Entity type:Individual
Prefix:
First Name:LIANYS
Middle Name:DELMIS
Last Name:CAMILLERI PERALTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26100 SW 144TH AVENUE RD # APPT301
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7424
Mailing Address - Country:US
Mailing Address - Phone:786-752-0632
Mailing Address - Fax:
Practice Address - Street 1:26100 SW 144TH AVENUE RD # APPT301
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-7424
Practice Address - Country:US
Practice Address - Phone:786-752-0632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-27
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician