Provider Demographics
NPI:1851339881
Name:VILLAMAN, YVELICE ANTONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:YVELICE
Middle Name:ANTONIA
Last Name:VILLAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7857 NW 192ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2757
Mailing Address - Country:US
Mailing Address - Phone:305-469-9718
Mailing Address - Fax:305-857-0653
Practice Address - Street 1:17900NW5TH ST 103
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2809
Practice Address - Country:US
Practice Address - Phone:954-392-0333
Practice Address - Fax:954-392-0393
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23924Medicare ID - Type Unspecified