Provider Demographics
NPI:1578758587
Name:ALFONSO LLANO MD PLLC
Entity Type:Organization
Organization Name:ALFONSO LLANO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:LLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-560-1680
Mailing Address - Street 1:2060 THOMAS BISHOP LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1143
Mailing Address - Country:US
Mailing Address - Phone:757-560-1680
Mailing Address - Fax:757-496-5274
Practice Address - Street 1:2060 THOMAS BISHOP LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-1143
Practice Address - Country:US
Practice Address - Phone:757-560-1680
Practice Address - Fax:757-496-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101223311208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty