Provider Demographics
NPI:1619911955
Name:VILAR, CARLOS ALBERTO (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:VILAR
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5637 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1015
Mailing Address - Country:US
Mailing Address - Phone:305-815-9208
Mailing Address - Fax:305-266-1781
Practice Address - Street 1:5637 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1015
Practice Address - Country:US
Practice Address - Phone:305-815-9208
Practice Address - Fax:305-266-1781
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLARNP9262155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL760994900Medicaid