Provider Demographics
NPI:1114229424
Name:LUIS M. LLAMAS, D.D.S, P.A.
Entity Type:Organization
Organization Name:LUIS M. LLAMAS, D.D.S, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS M.
Authorized Official - Middle Name:M
Authorized Official - Last Name:LLAMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-662-7702
Mailing Address - Street 1:5965 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2436
Mailing Address - Country:US
Mailing Address - Phone:305-662-7702
Mailing Address - Fax:305-662-2552
Practice Address - Street 1:5965 PONCE DE LEON BLVD
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2436
Practice Address - Country:US
Practice Address - Phone:305-662-7702
Practice Address - Fax:305-662-2552
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUIS M. LLAMAS, D.D.S, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN83631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty