Individual
FERNANDO VILELA VIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 250-2506
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
ME134152
FL
2085N0904X
Nuclear Radiology Physician
Primary
ME134152
FL
2085R0202X
Diagnostic Radiology Physician
ME134152
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103296200
—
FL
01
—
USKGW
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/16/2018
Last updated
04/01/2021
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