Provider Demographics
NPI:1356730733
Name:VILELLA, ANTONIA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:
Last Name:VILELLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S TAMIAMI TRL DEPT OF
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3555
Mailing Address - Country:US
Mailing Address - Phone:941-917-2525
Mailing Address - Fax:
Practice Address - Street 1:1700 S TAMIAMI TRL DEPT OF
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3555
Practice Address - Country:US
Practice Address - Phone:941-917-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS50888OtherDEPARTMENT OF HEALTH