Provider Demographics
NPI:1386344042
Name:VERDECIA, LINA (AP)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:VERDECIA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 SW 149TH CT UNIT 8209
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3105
Mailing Address - Country:US
Mailing Address - Phone:786-416-5405
Mailing Address - Fax:
Practice Address - Street 1:6741 SW 24TH ST STE 42
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1767
Practice Address - Country:US
Practice Address - Phone:786-644-5691
Practice Address - Fax:786-980-2430
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4432171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist