Provider Demographics
NPI:1114788064
Name:BRIAN VILLA, MD PLLC
Entity Type:Organization
Organization Name:BRIAN VILLA, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-495-9014
Mailing Address - Street 1:1818 W FLAGLER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1915
Mailing Address - Country:US
Mailing Address - Phone:305-495-9014
Mailing Address - Fax:305-402-0941
Practice Address - Street 1:1818 W FLAGLER ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1915
Practice Address - Country:US
Practice Address - Phone:305-495-9014
Practice Address - Fax:305-402-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty