Provider Demographics
NPI:1932483971
Name:VILLARD, MYRIAM (RPH)
Entity Type:Individual
Prefix:
First Name:MYRIAM
Middle Name:
Last Name:VILLARD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6558 LANTANA RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6508
Mailing Address - Country:US
Mailing Address - Phone:561-969-2429
Mailing Address - Fax:561-969-7510
Practice Address - Street 1:13887 80TH LANE N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412
Practice Address - Country:US
Practice Address - Phone:954-646-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL027260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist