Provider Demographics
NPI:1578386934
Name:MANWANI, LILIANA
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:MANWANI
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 1:4277 VINEYARD CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33332-2154
Mailing Address - Country:US
Mailing Address - Phone:956-744-2450
Mailing Address - Fax:
Practice Address - Street 1:1806 N FLAMINGO RD STE 110
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1027
Practice Address - Country:US
Practice Address - Phone:561-892-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-355818106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician