MEDICARE: ADRIANA VILLA MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME101671	FL

General Provider Information

NPI Number	:	1184911505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADRIANA VILLA MD PA

Provider Business Mailing Address
First Line	:	2566 TRAPP AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3839
Country	:	US
Telephone Number	:	305-606-2924
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 S DIXIE HWY
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33133-3137
Country	:	US
Telephone Number	:	305-857-3517
Fax Number	:	305-857-3518

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ADRIANA VILLA
Credential	:	MD
Telephone Number	:	305-606-2924

Provider Enumeration Date	:	07/06/2011
Last Update Date	:	04/12/2013

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