Provider Demographics
NPI:1932195435
Name:VILLOTTI, JAMES PHILLIP JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIP
Last Name:VILLOTTI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:900 PINE ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4418
Mailing Address - Country:US
Mailing Address - Phone:941-681-3333
Mailing Address - Fax:941-475-0748
Practice Address - Street 1:900 PINE ST
Practice Address - Street 2:SUITE 111
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4418
Practice Address - Country:US
Practice Address - Phone:941-681-3333
Practice Address - Fax:941-681-3335
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2019-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0038529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D51986Medicare UPIN
FL08106AMedicare ID - Type Unspecified