Healthcare Provider Details

I. General information

NPI: 1669812061
Provider Name (Legal Business Name): BARBARA ISABEL LLANES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BARBARA ISABEL DIAZ M.D.

II. Dates (important events)

Enumeration Date: 06/28/2013
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28610 SW 157TH AVE
HOMESTEAD FL
33033-1234
US

IV. Provider business mailing address

22775 SW 179TH AVE
MIAMI FL
33170-3620
US

V. Phone/Fax

Practice location:
  • Phone: 305-266-2929
  • Fax:
Mailing address:
  • Phone: 786-523-1502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN595
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: