Healthcare Provider Details

I. General information

NPI: 1871128041
Provider Name (Legal Business Name): ALLIE LLANERAS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6840 SW 40TH ST STE 211A
MIAMI FL
33155-3756
US

IV. Provider business mailing address

711 ORIOLE AVE
MIAMI SPRINGS FL
33166-3811
US

V. Phone/Fax

Practice location:
  • Phone: 470-230-5461
  • Fax:
Mailing address:
  • Phone: 305-804-8935
  • 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: