MEDICARE: VIRGINIA LLANOS R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	23024	PR

General Provider Information

NPI Number	:	1730417858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA LLANOS R.N.

Provider Business Mailing Address
First Line	:	PO BOX 1128
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-1128
Country	:	US
Telephone Number	:	787-382-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND MAGA
Second Line	:	PABELLON G
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1966
Country	:	US
Telephone Number	:	787-382-3353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2009
Last Update Date	:	12/01/2009

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