Individual
DR. BRUCE VILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP PATHOLOGY DEPT., JACKSONVILLE, FL 32209-6511
(904) 244-4861
(904) 244-4290
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
ME54731
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME54731
FL
Other
Enumeration date
03/21/2006
Last updated
08/25/2007
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