Provider Demographics
NPI:1548062110
Name:LLANES, CAMILA (OTR/L)
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:LLANES
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 SW 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1045
Mailing Address - Country:US
Mailing Address - Phone:786-218-9974
Mailing Address - Fax:
Practice Address - Street 1:6161 WATERFORD DISTRICT DR STE 150
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2024
Practice Address - Country:US
Practice Address - Phone:786-218-9974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25780225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist