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General NPI Number Information
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NPI Number | 1194938209
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Entity Type | Individual
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Provider Name | BERNARDO ANTONIO VILLELA DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8500 W FLAGLER ST STE 108A
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City | MIAMI
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State | FL
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Zip | 33144-2054
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Country | US
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Telephone | 305-551-2722
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Fax | 305-551-3826
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Provider Business Mailing Address
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Address Line | 8500 W FLAGLER ST STE 108A
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City | MIAMI
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State | FL
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Zip | 33144-2054
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Country | US
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Telephone | 305-551-2722
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Fax | 305-551-3826
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN9923
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License Number State | FL
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