Healthcare Provider Details

I. General information

NPI: 1437666492
Provider Name (Legal Business Name): REY LLANES ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 12/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E HILLSBORO BLVD
DEERFIELD BEACH FL
33441-4355
US

IV. Provider business mailing address

11944 NW 91ST PL
HIALEAH FL
33018-4181
US

V. Phone/Fax

Practice location:
  • Phone: 305-370-4921
  • Fax:
Mailing address:
  • Phone: 305-370-4921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9372976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: