Healthcare Provider Details

I. General information

NPI: 1649707860
Provider Name (Legal Business Name): PEDRO LLANES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 SW 8TH ST STE 308
MIAMI FL
33144-4132
US

IV. Provider business mailing address

8300 SW 8TH ST STE 308
MIAMI FL
33144-4132
US

V. Phone/Fax

Practice location:
  • Phone: 305-263-5346
  • Fax:
Mailing address:
  • Phone: 305-263-5346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: