Provider Demographics
NPI:1548072960
Name:LLANO LABRADOR, DANNIS
Entity type:Individual
Prefix:
First Name:DANNIS
Middle Name:
Last Name:LLANO LABRADOR
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 1:550 SE 30TH DR
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5767
Mailing Address - Country:US
Mailing Address - Phone:305-786-1564
Mailing Address - Fax:
Practice Address - Street 1:550 SE 30TH DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5767
Practice Address - Country:US
Practice Address - Phone:305-786-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCM.0107315-P104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker