Provider Demographics
NPI:1760098818
Name:VILLA, MARIA ALEXANDRIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEXANDRIA
Last Name:VILLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 BRICKELL BAY DR APT 1424
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2926
Mailing Address - Country:US
Mailing Address - Phone:786-314-6304
Mailing Address - Fax:
Practice Address - Street 1:3007 AVENTURA BLVD BAY 4
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3106
Practice Address - Country:US
Practice Address - Phone:305-936-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist