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General NPI Number Information
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NPI Number | 1861205387
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Entity Type | Individual
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Provider Name | VICENTE LLAMELO MAGALLANES JR. RN
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Gender | Male
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1505 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-1134
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Country | US
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Telephone | 352-265-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 13803 SW 137TH CT
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City | NEWBERRY
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State | FL
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Zip | 32669-4036
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Country | US
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Telephone | 352-538-8486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN9407148
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License Number State | FL
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