Provider Demographics
NPI:1194825661
Name:VILLOTA, FRANCISCO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:VILLOTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 LAWRENCE RD.
Mailing Address - Street 2:APT. 6-F
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4225
Mailing Address - Country:US
Mailing Address - Phone:609-406-0671
Mailing Address - Fax:
Practice Address - Street 1:550 LAWRENCE RD.
Practice Address - Street 2:APT. 6-F
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4225
Practice Address - Country:US
Practice Address - Phone:609-406-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07550900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061026Medicaid
NJ0061026Medicaid
NJ076677Medicare PIN