Provider Demographics
NPI:1013249655
Name:CHARLES A VILLOCH CARDIOLOGY MD PA
Entity type:Organization
Organization Name:CHARLES A VILLOCH CARDIOLOGY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:VILLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-858-2211
Mailing Address - Street 1:2075 SW 27TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2540
Mailing Address - Country:US
Mailing Address - Phone:305-858-2211
Mailing Address - Fax:305-856-5252
Practice Address - Street 1:2075 SW 27TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2540
Practice Address - Country:US
Practice Address - Phone:305-858-2211
Practice Address - Fax:305-856-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty