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Individual

MRS. DEISE VILLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3100 SW 62ND AVE, PEDIATRIC CARE CENTER DEPT., MIAMI, FL 33155-3009
(305) 669-6505
(305) 669-6447
Mailing address
PO BOX 557367, MIAMI, FL 33255-7367
(305) 669-6505
(305) 669-6447

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 59830
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
268411000
FL
Enumeration date
07/13/2006
Last updated
06/24/2008
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