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Liliya Heretsun-roussonicolos
Durable Medical Equipment & Medical Supplies in Port St Lucie, Florida
NPI 1407464506

Liliya Heretsun-roussonicolos is a Durable Medical Equipment & Medical Supplies based in Port St Lucie, FL. Liliya Heretsun-roussonicolos practices in Port St Lucie, FL. The NPI Number for Liliya Heretsun-roussonicolos is 1407464506 and holds a License No. (Florida).

The current practice location address for Liliya Heretsun-roussonicolos is 1488 Se Village Green Dr, Port St Lucie, FL and can be reached out via phone at 722-301-1497 and via fax at 321-676-8508.

Location: 1488 Se Village Green Dr, Port St Lucie, FL, 34952-3411
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407464506
Provider Name
Liliya Heretsun-roussonicolos
Credential
Provider Entity Type
Individual
Gender
Female
Address
1488 Se Village Green Dr, Port St Lucie, FL, 34952-3411
Phone Number
722-301-1497
Fax Number
321-676-8508
Provider Enumeration Date
07/15/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1488 Se Village Green Dr
City
Port St Lucie
State
Florida
Zip
34952-3411
Phone Number
722-301-1497
Fax Number
321-676-8508
person
Provider Business Mailing Address Details
Address
1488 Se Village Green Dr
City
Port St Lucie
State
Florida
Zip
34952-3411
Phone Number
722-301-1497
Fax Number
321-676-8508
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
(Florida)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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