Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Liliya Heretsun-Roussonicolos

Individual provider Durable Medical Equipment & Medical Supplies · NPI 1407464506

Liliya Heretsun-Roussonicolos is a Durable Medical Equipment & Medical Supplies in Port St Lucie, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2020

Practice location Address checks out

1488 SE Village Green Dr
Port St Lucie, FL 34952-3411
Phone: (722) 301-1497
Fax: (321) 676-8508
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X (FL)

Record details

NPI number1407464506
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 15, 2020
Last updated in NPPESOctober 9, 2020
Certification dateOctober 9, 2020

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