Individual
LAWANZA LLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1911 E 143RD AVE, TAMPA, FL 33613-2536
(813) 562-3555
(813) 252-6006
Mailing address
1911 E 143RD AVE, TAMPA, FL 33613-2536
(813) 562-3555
(813) 252-6006
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906889
FL
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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