Provider Demographics
NPI:1205416955
Name:FLEITES LLANIO, ROLANDO AGUSTIN (ARNP)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:AGUSTIN
Last Name:FLEITES LLANIO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:ROLANDO
Other - Middle Name:AGUSTIN
Other - Last Name:FLEITES LLANIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:8501 SW 124TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4631
Mailing Address - Country:US
Mailing Address - Phone:786-808-8555
Mailing Address - Fax:786-360-1100
Practice Address - Street 1:8501 SW 124TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4631
Practice Address - Country:US
Practice Address - Phone:786-808-8555
Practice Address - Fax:786-360-1100
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF03211250363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health