MEDICARE: LLANES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1902722176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LLANES INC

Provider Business Mailing Address
First Line	:	791 DILLARD DR SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-2368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	791 DILLARD DR SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-2368
Country	:	US
Telephone Number	:	321-989-5378
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERETOR
Name	:	JORGE A MORALES
Credential	:
Telephone Number	:	321-989-5378

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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Directions to “LLANES INC ” Practice Location

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