Individual
KEVIN LAZARO LLERENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
664 E 25TH ST STE 102, HIALEAH, FL 33013-3806
(786) 409-2651
Mailing address
691 E 24TH ST, HIALEAH, FL 33013-3925
(786) 681-3947
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
31742
FL
Other
Enumeration date
01/30/2022
Last updated
01/30/2022
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