Provider Demographics
NPI:1053063511
Name:ADRIANA VILLALOBOS MA, INC
Entity Type:Organization
Organization Name:ADRIANA VILLALOBOS MA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:239-777-2089
Mailing Address - Street 1:3392 TIMBERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-5630
Mailing Address - Country:US
Mailing Address - Phone:239-777-2089
Mailing Address - Fax:
Practice Address - Street 1:3392 TIMBERWOOD CIR OFC
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5630
Practice Address - Country:US
Practice Address - Phone:239-777-2089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY994OtherFLORIDA DEPARTMENT OF HEALTH