Healthcare Provider Details

I. General information

NPI: 1316367543
Provider Name (Legal Business Name): MARIA PILAR LLANOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8785 SW 165TH AVE STE 103
MIAMI FL
33193-5827
US

IV. Provider business mailing address

8785 SW 165TH AVE STE 103
MIAMI FL
33193-5827
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-6500
  • Fax:
Mailing address:
  • Phone: 786-206-6500
  • Fax: 772-675-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: