Provider Demographics
NPI:1629864327
Name:LEDON MANRESA, LIUDMILA
Entity type:Individual
Prefix:
First Name:LIUDMILA
Middle Name:
Last Name:LEDON MANRESA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6322 PALMA DEL MAR BLVD S APT 506
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1253
Mailing Address - Country:US
Mailing Address - Phone:813-956-2563
Mailing Address - Fax:
Practice Address - Street 1:400 N ASHLEY DR STE 1900
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4311
Practice Address - Country:US
Practice Address - Phone:813-573-5824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician