Healthcare Provider Details

I. General information

NPI: 1720948565
Provider Name (Legal Business Name): RACHEL COLLADO LLANES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8914 SW 212TH LN
CUTLER BAY FL
33189-3858
US

IV. Provider business mailing address

8914 SW 212TH LN
CUTLER BAY FL
33189-3858
US

V. Phone/Fax

Practice location:
  • Phone: 305-283-3910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11042981
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: