Basic Information
| Provider Information | |||||||||
| NPI: | 1306965355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LLANOS | ||||||||
| FirstName: | NINCI | ||||||||
| MiddleName: | LIMARI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P34 CALLE GARDENIA | ||||||||
| Address2: | JARDINES DE BORINQUEN | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009854236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9394759036 | ||||||||
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| Practice Location | |||||||||
| Address1: | AVE LUIS MUNOZ MARIN ESQ DEGETAU | ||||||||
| Address2: | #100 | ||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007264980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876533434 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 10/09/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 16460 | PR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 16460 | 01 | PR | MEDICAL LIC | OTHER |