Healthcare Provider Details

I. General information

NPI: 1922327824
Provider Name (Legal Business Name): VMG URGENT CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 BUENOS AIRES BLVD SUITE B
THE VILLAGES FL
32159-8974
US

IV. Provider business mailing address

1507 BUENOS AIRES BLVD SUITE B
THE VILLAGES FL
32159-8974
US

V. Phone/Fax

Practice location:
  • Phone: 352-350-1600
  • Fax: 352-750-8032
Mailing address:
  • Phone: 352-350-1600
  • Fax: 352-750-8032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIVIC VILLA
Title or Position: PRESIDENT
Credential: MD
Phone: 352-350-1600