Provider Demographics
NPI:1811500994
Name:VILLA, ARMANDO
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:VILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 WEST 46TH ST
Mailing Address - Street 2:APT 531
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:786-899-9122
Mailing Address - Fax:
Practice Address - Street 1:1750 WEST 46TH ST
Practice Address - Street 2:APT 531
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6466
Practice Address - Country:US
Practice Address - Phone:786-899-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician