Physician Compare National (NPI:1326060203)

HEALTHCARE PROVIDER: ALEX LLARENA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326060203
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921295783
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101207000391
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LLARENA
	Individual professional last name
Provider First Name	ALEX
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1411 S 14TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	FERNANDINA BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	320343092
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9042617221
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100040
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST VINCENT'S MEDICAL CENTER RIVERSIDE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100140
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST MEDICAL CENTER NASSAU
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y