Provider Demographics
NPI:1215559836
Name:DAWES, LILLIAN MAY (LMT)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:MAY
Last Name:DAWES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14331 SW 120TH ST STE 211
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7297
Mailing Address - Country:US
Mailing Address - Phone:305-799-4769
Mailing Address - Fax:
Practice Address - Street 1:14331 SW 120TH ST STE 211
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7297
Practice Address - Country:US
Practice Address - Phone:305-799-4769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL80557225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist