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General NPI Number Information
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NPI Number | 1952479008
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Entity Type | Individual
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Provider Name | DR. PATRICK VILLICANA
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 350 NW 84TH AVE STE 300
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City | PLANTATION
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State | FL
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Zip | 33324-1859
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Country | US
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Telephone | 954-474-2929
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Fax | 954-474-9708
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Provider Business Mailing Address
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Address Line | 1419 SE 8TH TER STE 200
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City | CAPE CORAL
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State | FL
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Zip | 33990-3213
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Country | US
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Telephone | 239-931-7342
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Fax | 239-931-7385
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | TRN7728
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME105141
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License Number State | FL
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