Provider Demographics
NPI:1508838988
Name:VILLAFANE, BEATRIZ LILIANA (MD)
Entity Type:Individual
Prefix:MRS
First Name:BEATRIZ
Middle Name:LILIANA
Last Name:VILLAFANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
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:954-443-1988
Mailing Address - Fax:954-443-1989
Practice Address - Street 1:17900 NW 5TH ST STE 203A
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2827
Practice Address - Country:US
Practice Address - Phone:954-443-1988
Practice Address - Fax:954-443-1989
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME867172084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0664Medicare ID - Type Unspecified