Provider Demographics
NPI:1477885606
Name:LLPI HEALTHCARE ADVOCATES
Entity Type:Organization
Organization Name:LLPI HEALTHCARE ADVOCATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ILARIA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN,MS,CF,LHLA,LNC,
Authorized Official - Phone:904-540-5709
Mailing Address - Street 1:3028 ATHERLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-5052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:904-217-3170
Practice Address - Street 1:3028 ATHERLEY RD
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-5052
Practice Address - Country:US
Practice Address - Phone:904-994-3226
Practice Address - Fax:904-217-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF09000000292171M00000X, 302F00000X
PA3659481251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSARJOSH2OtherALL INSURANCE PAYEES
FLSARJOSH2OtherINSURANCE PROVIDERS DISCOUNT MARKET
FLSARJOSH2Medicaid
FLSARJOSH2Medicaid
FLSARJOSH2OtherINSURANCE PROVIDERS DISCOUNT MARKET