Provider Demographics
NPI:1235319724
Name:VILLAROSA, IMELDA (MD)
Entity Type:Individual
Prefix:DR
First Name:IMELDA
Middle Name:
Last Name:VILLAROSA
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 1:710 HART LN FL 3
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37243-0001
Mailing Address - Country:US
Mailing Address - Phone:615-650-7000
Mailing Address - Fax:615-262-6139
Practice Address - Street 1:710 HART LANE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37243-0001
Practice Address - Country:US
Practice Address - Phone:615-650-7000
Practice Address - Fax:615-262-6139
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35528207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN35528OtherMD