Provider Demographics
NPI:1578578910
Name:VILA, HECTOR (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:VILA
Suffix:
Gender:M
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:PO BOX 18664
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-8664
Mailing Address - Country:US
Mailing Address - Phone:813-545-9924
Mailing Address - Fax:813-282-8122
Practice Address - Street 1:4304 W AZEELE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3824
Practice Address - Country:US
Practice Address - Phone:813-545-9924
Practice Address - Fax:813-282-8122
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61169207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18926OtherBLUE CROSS BLUE SHIELD
FL261511800Medicaid
FL18926WMedicare ID - Type Unspecified
FLE69757Medicare UPIN