Organization
MEDICCI KLINX INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR VILLARROEL MD (PRESIDENT)
(912) 658-1155
Entity
Organization
Contact information
Practice address
1608 LINCOLNWAY STE C, VALPARAISO, IN 46383-5852
(219) 299-2075
Mailing address
1608 LINCOLNWAY STE C, VALPARAISO, IN 46383-5852
(219) 299-2075
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01068033A
IN
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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