Provider Demographics
NPI:1497629133
Name:BADILLO CINTRA, LIEINYS (PHLEBOTOMY)
Entity type:Individual
Prefix:
First Name:LIEINYS
Middle Name:
Last Name:BADILLO CINTRA
Suffix:
Gender:F
Credentials:PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13330 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-7916
Mailing Address - Country:US
Mailing Address - Phone:813-381-9505
Mailing Address - Fax:
Practice Address - Street 1:13318 DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-7916
Practice Address - Country:US
Practice Address - Phone:813-381-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31710577291U00000X, 246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No291U00000XLaboratoriesClinical Medical Laboratory