Healthcare Provider Details

I. General information

NPI: 1174128763
Provider Name (Legal Business Name): YAHAIRA LLANIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12650 SW 88TH ST
MIAMI FL
33186-1868
US

IV. Provider business mailing address

15506 SW 117TH ST
MIAMI FL
33196-6844
US

V. Phone/Fax

Practice location:
  • Phone: 305-274-2223
  • Fax:
Mailing address:
  • Phone: 305-283-3564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS38886
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: