Provider Demographics
NPI:1386456416
Name:WEGLAREK, LILY ANN (MS)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:ANN
Last Name:WEGLAREK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 SW 13TH ST APT 2325
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2136
Mailing Address - Country:US
Mailing Address - Phone:773-824-7784
Mailing Address - Fax:
Practice Address - Street 1:1699 SW 16TH AVE BLDG A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1158
Practice Address - Country:US
Practice Address - Phone:352-294-5050
Practice Address - Fax:352-294-8058
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLGC786170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS