Healthcare Provider Details

I. General information

NPI: 1154942225
Provider Name (Legal Business Name): ERIKA KRISTINA VILLALOBOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 NW 107TH PL
DORAL FL
33178-5237
US

IV. Provider business mailing address

95 CHRISTOPHER ST APT 9D
NEW YORK NY
10014-0793
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-4252
  • Fax:
Mailing address:
  • Phone: 315-560-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: