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General NPI Number Information
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NPI Number | 1053473132
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Entity Type | Organization
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Legal Business Name | POOLE AND VILLANI, M.D.,'S, P.A.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 1111 KANE CONCOURSE STE 607
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2044
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Country | US
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Telephone | 305-674-2047
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Fax | 305-674-2939
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Provider Business Mailing Address
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Address Line | 1111 KANE CONCOURSE STE 607
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2044
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Country | US
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Telephone | 305-674-2047
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Fax | 305-674-2939
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS DIEGO VILLANI
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Credential | MD
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Telephone | 305-674-2047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | FL
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