Healthcare Provider Details

I. General information

NPI: 1720641889
Provider Name (Legal Business Name): YADIRA VILLALVAZO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 5TH AVENUE FALK CLINIC SUITE 6B
PITTSBURGH PA
15213-3403
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER-PLAZA LEVEL SUITE140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-9670
  • Fax:
Mailing address:
  • Phone: 412-383-8080
  • Fax: 520-626-2247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR77390
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: