Healthcare Provider Details

I. General information

NPI: 1326667775
Provider Name (Legal Business Name): EDUARDO ARTURO VILLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 SOLE MIA WAY
NORTH MIAMI FL
33181-2492
US

IV. Provider business mailing address

951 BRICKELL AVE APT 2411
MIAMI FL
33131-3938
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6251
  • Fax: 305-243-3506
Mailing address:
  • Phone: 786-805-0844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME162784
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: