Healthcare Provider Details

I. General information

NPI: 1598115461
Provider Name (Legal Business Name): ELIZA MARIA LLANES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 SW 45TH ST
MIAMI FL
33175-4501
US

IV. Provider business mailing address

13001 SW 45TH ST
MIAMI FL
33175-4501
US

V. Phone/Fax

Practice location:
  • Phone: 786-399-4469
  • Fax:
Mailing address:
  • Phone: 786-399-4469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: