Individual
SUSANA VILLATE PRIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
155 KINGSLEY LN STE 400, NORFOLK, VA 23505-4629
(757) 278-2240
Mailing address
2728 W HANNON HILL DR, TALLAHASSEE, FL 32309-8944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101269901
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/14/2017
Last updated
07/01/2020
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