Provider Demographics
NPI:1427399153
Name:BEATRIZ L. VILLAFANE, MD, PA
Entity Type:Organization
Organization Name:BEATRIZ L. VILLAFANE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:LILIANA
Authorized Official - Last Name:VILLAFANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-202-0246
Mailing Address - Street 1:15460 NW 83RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5836
Mailing Address - Country:US
Mailing Address - Phone:786-202-0246
Mailing Address - Fax:954-443-1989
Practice Address - Street 1:735 COMMERCE CENTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3136
Practice Address - Country:US
Practice Address - Phone:954-443-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME867172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266472100Medicaid
FL266472100Medicaid