Individual
MRS. JUDY VILLALOBOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
9655 NW 41ST ST, DORAL, FL 33178-2973
(305) 436-1563
(305) 436-1564
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(305) 436-1563
(305) 436-1564
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104568
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002807900
—
FL
Enumeration date
07/02/2008
Last updated
06/10/2020
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