Provider Demographics
NPI:1982362117
Name:LLANES, ANIA (COTA)
Entity Type:Individual
Prefix:
First Name:ANIA
Middle Name:
Last Name:LLANES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 SE 32ND TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7251
Mailing Address - Country:US
Mailing Address - Phone:305-519-6906
Mailing Address - Fax:
Practice Address - Street 1:756 W PALM DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33034-3224
Practice Address - Country:US
Practice Address - Phone:305-246-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA13130224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty