Provider Demographics
NPI:1518490093
Name:LLANES, JULIA NURYS
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:NURYS
Last Name:LLANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8917 NW 112TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4575
Mailing Address - Country:US
Mailing Address - Phone:786-488-5555
Mailing Address - Fax:305-901-1797
Practice Address - Street 1:8917 NW 112TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4575
Practice Address - Country:US
Practice Address - Phone:786-488-5555
Practice Address - Fax:305-901-1797
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician