Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DEH 18811 | FL |
NPI | 1063720852 |
---|---|
Provider Name | Lynette Leanor Llinas |
First Address | Port Saint Lucie, FL 34987-1947 |
Second Address | Port Saint Lucie, FL 34987-1947 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 15/09/2010 |