Provider Demographics
NPI:1033955430
Name:LLANOS, LEISHLA MARIE
Entity type:Individual
Prefix:
First Name:LEISHLA
Middle Name:MARIE
Last Name:LLANOS
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 1:36 TERRALINDA ESTS
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-4091
Mailing Address - Country:US
Mailing Address - Phone:787-233-3699
Mailing Address - Fax:
Practice Address - Street 1:36 TERRALINDA ESTS
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-4091
Practice Address - Country:US
Practice Address - Phone:787-233-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3094163WI0500X
PR38256163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy