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NPI Code Detail

MEDICARE: VILLOCH ASSOCIATES MD, PA.

MEDICARE: VILLOCH ASSOCIATES 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
1173000000XLegal MedicineME59094FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111709OTHERFLBCBS

General Provider Information

NPI Number : 1326173881
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLOCH ASSOCIATES MD, PA.
Provider Business Mailing Address
First Line : 5005 ORDUNA DR
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-2036
Country : US
Telephone Number : 305-662-2592
Fax Number :
Provider Business Practice Location Address
First Line : 2075 SW 27TH AVE FL 1
Second Line :
City : MIAMI
State : FL
Zip : 33145-2540
Country : US
Telephone Number : 305-856-6081
Fax Number : 305-854-5968
Authorized Official
Title or Position : PRESIDENT
Name : DR. MARIO R VILLOCH
Credential : M.D.,
Telephone Number : 305-856-6081
Provider Enumeration Date : 02/23/2007
Last Update Date : 08/22/2020

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