Provider Demographics
NPI:1104600261
Name:KILIKU, BRIANA
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:KILIKU
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 1:2574 EMPRESS DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7996
Mailing Address - Country:US
Mailing Address - Phone:407-279-8413
Mailing Address - Fax:
Practice Address - Street 1:2574 EMPRESS DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-7996
Practice Address - Country:US
Practice Address - Phone:407-279-8413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant