Provider Demographics
NPI:1073703856
Name:OSCAR M. VILLAVERDE, M.D., P.A.
Entity Type:Organization
Organization Name:OSCAR M. VILLAVERDE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:VILLAVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-972-3291
Mailing Address - Street 1:8700 N KENDALL DR
Mailing Address - Street 2:SUITE 218
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2206
Mailing Address - Country:US
Mailing Address - Phone:305-274-7671
Mailing Address - Fax:305-598-7032
Practice Address - Street 1:8700 N KENDALL DR
Practice Address - Street 2:SUITE 218
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2206
Practice Address - Country:US
Practice Address - Phone:305-274-7671
Practice Address - Fax:305-598-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME869302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9112OtherMEDICARE GROUP IDENTIFICA
FLI48097Medicare UPIN