Provider Demographics
NPI:1902010861
Name:VILLATE, NATALIA (MD)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:VILLATE
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 1:850 S PINE ISLAND RD
Mailing Address - Street 2:SUITE A100
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3118
Mailing Address - Country:US
Mailing Address - Phone:954-741-5555
Mailing Address - Fax:954-572-9658
Practice Address - Street 1:850 S PINE ISLAND RD
Practice Address - Street 2:SUITE A100
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3118
Practice Address - Country:US
Practice Address - Phone:954-741-5555
Practice Address - Fax:954-572-9658
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0102239207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM206XMedicare PIN
FLAM206ZMedicare PIN
FLAM206YMedicare PIN