Provider Demographics
NPI:1083961312
Name:LUIS F. VILLAR M.D.,P.A.
Entity Type:Organization
Organization Name:LUIS F. VILLAR M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-286-3722
Mailing Address - Street 1:309 SE OSCEOLA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2251
Mailing Address - Country:US
Mailing Address - Phone:772-286-3722
Mailing Address - Fax:772-286-7096
Practice Address - Street 1:309 SE OSCEOLA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2251
Practice Address - Country:US
Practice Address - Phone:772-286-3722
Practice Address - Fax:772-286-7096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0039125207N00000X, 207ND0101X, 207ZP0102X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56770Medicare UPIN