Provider Demographics
NPI:1851767875
Name:LLANES, ANN-MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:
Last Name:LLANES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 290
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4552
Mailing Address - Country:US
Mailing Address - Phone:239-313-2517
Mailing Address - Fax:239-313-2555
Practice Address - Street 1:9015 US HIGHWAY 301 N
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-8673
Practice Address - Country:US
Practice Address - Phone:941-776-1577
Practice Address - Fax:941-776-1886
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-10172363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant