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LILIYA HERETSUN-ROUSSONICOLOS
NPI 1407464506
Durable Medical Equipment & Medical Supplies in Port St Lucie, FL

Active since July 15, 2020
1488 SE VILLAGE GREEN DR, PORT ST LUCIE, FL 34952(722) 301-1497(321) 676-8508 Get Directions Write a Review

NPPES record last updated: October 9, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 9, 2020, Jul 15, 2020 (2 updates tracked since 2020).

About Liliya Heretsun-roussonicolos NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LILIYA HERETSUN-ROUSSONICOLOS (NPI 1407464506) is an individual durable medical equipment & medical supplies provider in Port St Lucie, Florida and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1407464506
Entity TypeIndividualFemale
Primary Taxonomy332B00000X
Provider Legal NameLILIYA HERETSUN-ROUSSONICOLOS
Location Address1488 SE VILLAGE GREEN DRPort St Lucie, FL 34952-3411
Mailing Address1488 Se Village Green DrPort St Lucie, FL 34952-3411 · (772) 777-4745 · Fax (772) 777-4833
Phone(722) 301-1497
Fax(321) 676-8508
Sole ProprietorYes
Enumeration DateJuly 15, 2020
Last NPPES UpdateOctober 9, 20202 updates tracked since enumeration
NPPES CertifiedOctober 9, 2020
✔ NPI 1407464506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
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.
1488 SE VILLAGE GREEN DR, Port St Lucie, FL 34952
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IKU MARKETING, LLC
Durable Medical Equipment & Medical Supplies
1488 SE VILLAGE GREEN DR
PORT SAINT LUCIE, FL 34952
St. Lucie County (772) 777-4745

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Liliya Heretsun-roussonicolos's NPI number?

The NPI number for Liliya Heretsun-roussonicolos is 1407464506. It was assigned to this individual provider in the NPPES registry on July 15, 2020.

Where is Liliya Heretsun-roussonicolos located?

Liliya Heretsun-roussonicolos practices at 1488 SE Village Green Dr, Port St Lucie, FL 34952. The listed phone number is (722) 301-1497.

What is Liliya Heretsun-roussonicolos's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Liliya Heretsun-roussonicolos was last updated on October 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.