Provider Demographics
NPI:1821538372
Name:MARIA THERESA F. VILLA, M.D. LLC
Entity Type:Organization
Organization Name:MARIA THERESA F. VILLA, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA THERESA
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-845-3911
Mailing Address - Street 1:634 KALIHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4000
Mailing Address - Country:US
Mailing Address - Phone:808-845-3911
Mailing Address - Fax:808-848-0870
Practice Address - Street 1:634 KALIHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4000
Practice Address - Country:US
Practice Address - Phone:808-845-3911
Practice Address - Fax:808-848-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD18655207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty