Healthcare Provider Details

I. General information

NPI: 1477885606
Provider Name (Legal Business Name): LLPI HEALTHCARE ADVOCATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2010
Last Update Date: 02/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3028 ATHERLEY RD
SAINT AUGUSTINE FL
32092-5052
US

IV. Provider business mailing address

3028 ATHERLEY RD
SAINT AUGUSTINE FL
32092-5052
US

V. Phone/Fax

Practice location:
  • Phone: 904-994-3226
  • Fax: 904-217-3170
Mailing address:
  • Phone:
  • Fax: 904-217-3170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberF09000000292
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number3659481
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberF09000000292
License Number StateFL

VIII. Authorized Official

Name: PAMELA M ILARIA
Title or Position: PRESIDENT
Credential: BSN,MS,CF,LHLA,LNC,
Phone: 904-540-5709