Healthcare Provider Details

I. General information

NPI: 1487583977
Provider Name (Legal Business Name): MR. MANUEL ALEJANDRO LLAVONA RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 5, AVENIDA CENTRAL JUANITA FINAL
BAYAMON PR
00960
US

IV. Provider business mailing address

LOS ARBOLES DE MONTEHIEDRA 456 CALLE BAUHINIA
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-488-1300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: