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General NPI Number Information
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NPI Number | 1497589824
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Entity Type | Individual
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Provider Name | OSMANY ANIBAL VILLA ZABALA
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Gender | Male
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 11780 SW 89TH ST STE 204
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City | MIAMI
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State | FL
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Zip | 33186-2181
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Country | US
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Telephone | 786-536-5765
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Fax |
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Provider Business Mailing Address
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Address Line | 9085 SW 165TH PL
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City | MIAMI
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State | FL
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Zip | 33196
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Country | US
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Telephone |
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Fax |
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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 | 11032376
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License Number State | FL
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