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General NPI Number Information
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NPI Number | 1407491525
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Entity Type | Individual
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Provider Name | CHRISTIAN DE VILLAFUERTE APRN
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Gender | Male
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 21550 BISCAYNE BLVD STE 131
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City | AVENTURA
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State | FL
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Zip | 33180-1258
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Country | US
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Telephone | 305-814-3376
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Fax | 305-939-5928
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Provider Business Mailing Address
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Address Line | 21550 BISCAYNE BLVD STE 131
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City | AVENTURA
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State | FL
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Zip | 33180-1258
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Country | US
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Telephone | 305-814-3376
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Fax | 305-939-5928
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11003547
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License Number State | FL
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