Provider Demographics
NPI:1780047654
Name:ANON VILA, ANABEL (MD)
Entity type:Individual
Prefix:
First Name:ANABEL
Middle Name:
Last Name:ANON VILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANABEL
Other - Middle Name:
Other - Last Name:ANON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17 DAVIS BLVD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3475
Mailing Address - Country:US
Mailing Address - Phone:813-250-2506
Mailing Address - Fax:
Practice Address - Street 1:17 DAVIS BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3475
Practice Address - Country:US
Practice Address - Phone:813-972-7688
Practice Address - Fax:813-631-3130
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME136579208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program