Provider Demographics
NPI:1538494265
Name:LLANA, ENVER (RCS)
Entity type:Individual
Prefix:MR
First Name:ENVER
Middle Name:
Last Name:LLANA
Suffix:
Gender:M
Credentials:RCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28839 FLORAL ST
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-7420
Mailing Address - Country:US
Mailing Address - Phone:586-757-3300
Mailing Address - Fax:586-757-3301
Practice Address - Street 1:25500 SHERWOOD AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-4154
Practice Address - Country:US
Practice Address - Phone:586-757-3300
Practice Address - Fax:586-757-3301
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI00074367246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology