Provider Demographics
NPI:1568238020
Name:VILLAMIL, LUIS (LMFT)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:VILLAMIL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21132 SW 91ST CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3896
Mailing Address - Country:US
Mailing Address - Phone:786-286-5355
Mailing Address - Fax:
Practice Address - Street 1:17000 NW 67TH AVE APT 236
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33015-4061
Practice Address - Country:US
Practice Address - Phone:786-286-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3303106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist