Provider Demographics
NPI:1114137809
Name:VILLA, ADRIANA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:MARIA
Last Name:VILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6436
Mailing Address - Country:US
Mailing Address - Phone:305-606-2924
Mailing Address - Fax:
Practice Address - Street 1:3661 S MIAMI AVE STE 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4232
Practice Address - Country:US
Practice Address - Phone:305-606-2924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 101671207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology