Individual
IDANIA VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL ASST.
Contact information
Practice address
9160 NW 122ND ST, HIALEAH GARDENS, FL 33018-1730
(305) 828-7870
Mailing address
7125 NW 186TH ST APT B501, HIALEAH, FL 33015-8340
(786) 368-3213
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
206309
MA
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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