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General NPI Number Information
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NPI Number | 1811480528
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Entity Type | Individual
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Provider Name | YILAIDIS VILLALOBO
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Gender | Female
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 8555 NE 2ND AVE
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City | EL PORTAL
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State | FL
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Zip | 33138-3001
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Country | US
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Telephone | 305-758-5878
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Fax | 786-991-9371
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Provider Business Mailing Address
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Address Line | 8335 SW 152ND AVE APT B-102
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City | MIAMI
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State | FL
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Zip | 33193-4015
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Country | US
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Telephone | 305-219-6003
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN25336
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License Number State | FL
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