Provider Demographics
NPI:1033949862
Name:LILIE AND RAY LLC
Entity type:Organization
Organization Name:LILIE AND RAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REMY
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-526-0984
Mailing Address - Street 1:6417 114TH AVE E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-3427
Mailing Address - Country:US
Mailing Address - Phone:813-526-0984
Mailing Address - Fax:
Practice Address - Street 1:6417 114TH AVE E
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-3427
Practice Address - Country:US
Practice Address - Phone:813-526-0984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty