Healthcare Provider Details

I. General information

NPI: 1518512219
Provider Name (Legal Business Name): VILLAGES HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 12/23/2019
Certification Date: 12/23/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 SANTA BARBARA BLVD STE A
THE VILLAGES FL
32159-6820
US

IV. Provider business mailing address

1585 SANTA BARBARA BLVD STE A
THE VILLAGES FL
32159-6820
US

V. Phone/Fax

Practice location:
  • Phone: 352-430-2121
  • Fax:
Mailing address:
  • Phone: 352-430-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE THOMAS RESTIERI
Title or Position: OWNER
Credential: DC
Phone: 386-454-3941