Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME147654 | FL |
NPI | 1063831311 |
---|---|
Provider Name | Juliana Andrea Llano |
First Address | Fort Myers, FL 33901-9342 |
Second Address | Jacksonville, FL 32225-7428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 11/08/2021 |