Provider Demographics
NPI:1558078741
Name:VILLASANTE ABELLAS, MABEL
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:VILLASANTE ABELLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10245 NW 9TH STREET CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-6607
Mailing Address - Country:US
Mailing Address - Phone:305-389-6421
Mailing Address - Fax:
Practice Address - Street 1:10245 NW 9TH STREET CIR APT 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-6607
Practice Address - Country:US
Practice Address - Phone:305-389-6421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily