Decosimo, Lillian Marie

Decosimo, Lillian Marie is an sole proprietor health care provider with primary practice located at 3100 Sw 62Nd Ave Fetalcare Center/ Special Delivery Unit, Miami FL 33155-3009. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Decosimo, Lillian Marie can be contacted via phone (786) 624-3509.

Contact Information

Primary practice address
3100 Sw 62Nd Ave Fetalcare Center/ Special Delivery Unit Miami FL 33155-3009
Phone: (786) 624-3509
Fax: (844) 898-2182
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101053044 Virginia
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME131219 Florida

Profile Details

NPI number 1336119783
LBN Legal business name Decosimo, Lillian Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2006
Last updated Apr 22nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336119783 NPPES
Florida MEDICAID 024734400
Florida MEDICAID 6201547

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