Individual ProviderLisett Duque MandriBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address15328 SW 53rd St, Miami, FL 33185-4264(786) 337-5121PECOS EnrollmentBased on the most recent information from CMS, provider Lisett Duque Mandri does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1760151344Provider TypeIndividualFull NameDuque Mandri, LisettGenderFemaleSole ProprietorNoEnumeration Date9/8/2021Last Updated9/8/2021Contact InformationPractice LocationPractice Address15328 SW 53rd St, Miami, FL 33185-4264Phone(786) 337-5121FaxUnlisted FaxMailing LocationMailing Address15328 SW 53rd St, Miami, FL 33185-4264Phone(786) 337-5121FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicense18-65687