Healthcare Provider Details

I. General information

NPI: 1225829385
Provider Name (Legal Business Name): MAIRELYS LLANES BALVERDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3156 NW 92ND ST
MIAMI FL
33147-3459
US

IV. Provider business mailing address

3156 NW 92ND ST
MIAMI FL
33147-3459
US

V. Phone/Fax

Practice location:
  • Phone: 786-258-3181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: