Healthcare Provider Details

I. General information

NPI: 1851767875
Provider Name (Legal Business Name): ANN-MARIE LLANES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9015 US HIGHWAY 301 N
PARRISH FL
34219-8673
US

IV. Provider business mailing address

900 VILLAGE SQUARE XING STE 290
PALM BEACH GARDENS FL
33410-4552
US

V. Phone/Fax

Practice location:
  • Phone: 941-776-1577
  • Fax: 941-776-1886
Mailing address:
  • Phone: 239-313-2517
  • Fax: 239-313-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-10172
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: