Individual provider Active NPI

Lianny Paneque Pillo, NP-BC

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1750279840
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11039419 Issued in FL
Practice address
1701 SE Hillmoor Dr Ste 7
Port St Lucie, FL 34952-7552
Phone
(772) 480-5860
NPI assigned
Jun 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11039419 FL Primary

Addresses

Primary practice location

1701 SE Hillmoor Dr Ste 7
Port St Lucie, FL 34952-7552

Mailing address

7447 Amethyst Ave
Grant, FL 32949-8259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250725002942 FL Practitioner - Nurse Practitioner 0446767321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edgar R Blecker MD PA CurrentSince Oct 9, 2025 Accepting new patients

Locations

229 Sebastian Blvd
Sebastian, FL 32958
Phone (772) 581-0016

Interoperability endpoints

  • Direct secure messaging: lianny.paneque.pillo.1@25403.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GDIGAD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1750279840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 AMETHYST AVE",
            "city": "GRANT",
            "state": "FL",
            "postal_code": "329498259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR STE 7",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527552",
            "telephone_number": "772-480-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANEQUE PILLO",
        "first_name": "LIANNY",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11039419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.