Provider Demographics
NPI:1669861407
Name:MONTOYA, LILIANA (MD)
Entity type:Individual
Prefix:DR
First Name:LILIANA
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7172
Mailing Address - Country:US
Mailing Address - Phone:866-400-3376
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:1905 CLINT MOORE RD STE 103
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2659
Practice Address - Country:US
Practice Address - Phone:866-400-3376
Practice Address - Fax:561-241-9667
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME175482207N00000X
IL036.146452207N00000X
IL125066312208000000X
AZ62897207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.146452Medicaid