Healthcare Provider Details

I. General information

NPI: 1063208106
Provider Name (Legal Business Name): ZAYDA VILLATORO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7226 LEE DEFOREST DR STE 206
COLUMBIA MD
21046-3238
US

IV. Provider business mailing address

7226 LEE DEFOREST DR STE 206
COLUMBIA MD
21046-3238
US

V. Phone/Fax

Practice location:
  • Phone: 410-656-2646
  • Fax:
Mailing address:
  • Phone: 410-656-2646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: