Provider Demographics
NPI:1689250136
Name:LEANILLO, FLORENTINO TANTOY
Entity Type:Individual
Prefix:MR
First Name:FLORENTINO
Middle Name:TANTOY
Last Name:LEANILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 CORDONE AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2603
Mailing Address - Country:US
Mailing Address - Phone:775-800-1228
Mailing Address - Fax:775-800-1228
Practice Address - Street 1:975 CORDONE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2603
Practice Address - Country:US
Practice Address - Phone:775-800-1228
Practice Address - Fax:775-800-1228
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal