Provider Demographics
NPI:1114246725
Name:JAVIER FRANCISCO VILASUSO MD PPLC
Entity Type:Organization
Organization Name:JAVIER FRANCISCO VILASUSO MD PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:F
Authorized Official - Last Name:VILASUSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-661-3502
Mailing Address - Street 1:2601 SW 37TH AVE
Mailing Address - Street 2:SUITE 704
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2750
Mailing Address - Country:US
Mailing Address - Phone:305-448-8455
Mailing Address - Fax:305-448-5882
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:SUITE 704
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2750
Practice Address - Country:US
Practice Address - Phone:305-448-8455
Practice Address - Fax:305-448-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106794208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty