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General NPI Number Information
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NPI Number | 1013249655
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Entity Type | Organization
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Legal Business Name | CHARLES A VILLOCH CARDIOLOGY MD PA
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Dates
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Enumeration Date | 02/08/2010
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Last Update Date | 02/08/2010
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Provider Practice Location Address
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Address Line | 2075 SW 27TH AVE 2ND FLOOR
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City | MIAMI
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State | FL
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Zip | 33145-2540
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Country | US
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Telephone | 305-858-2211
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Fax | 305-856-5252
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Provider Business Mailing Address
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Address Line | 2075 SW 27TH AVE 2ND FLOOR
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City | MIAMI
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State | FL
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Zip | 33145-2540
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Country | US
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Telephone | 305-858-2211
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Fax | 305-856-5252
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES A VILLOCH
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Credential | MD
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Telephone | 305-858-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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