| Dr Lillian Marie Decosimo, MD | |
|
5200 N Ocean Blvd Apt 706, Lauderdale By The Sea, FL 33308-3018 | |
| (703) 859-5225 | |
| (844) 898-2182 |
| Full Name | Dr Lillian Marie Decosimo |
|---|---|
| Gender | Female |
| Speciality | Obstetrics & Gynecology |
| Location | 5200 N Ocean Blvd Apt 706, Lauderdale By The Sea, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336119783 | NPI | - | NPPES |
| 024734400 | Medicaid | FL | |
| 6201547 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | ME131219 (Florida) | Primary |
| 174400000X | Specialist | 0101053044 (Virginia) | Secondary |
| Entity Name | Inova Health Care Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952320061 PECOS PAC ID: 2466351093 Enrollment ID: O20080806000696 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Lillian Marie Decosimo, MD 5200 N Ocean Blvd Apt 706, Lauderdale By The Sea, FL 33308-3018 Ph: (703) 859-5225 | Dr Lillian Marie Decosimo, MD 5200 N Ocean Blvd Apt 706, Lauderdale By The Sea, FL 33308-3018 Ph: (703) 859-5225 |
Dr. Reynald Pouliot, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 265b Commercial Blvd, Lauderdale By The Sea, FL 33308 Phone: 954-772-3960 Fax: 954-772-3981 | |
Laurel Hallson, Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 4401 W Tradewinds Ave, Lauderdale By The Sea, FL 33308 Phone: 954-817-5653 Fax: 954-776-6969 | |
Marielena Guerra, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 265 Commercial Blvd, Lauderdale By The Sea, FL 33308 Phone: 954-772-3960 Fax: 855-494-7111 |