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Individual

DR. JUAN VILLAFANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
731 E BROADWAY, LOUISVILLE, KY 40202-1711
(502) 584-3200
(502) 584-3333
Mailing address
743 E BROADWAY # 300, LOUISVILLE, KY 40202-1711
(502) 584-3200
(502) 584-3333

Taxonomy

Speciality
Code
Description
License number
State
207RA0002X
Adult Congenital Heart Disease Physician
Primary
24893
KY
2080P0202X
Pediatric Cardiology Physician
24893
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100020940
IN
05
64248933
KY
Enumeration date
02/13/2007
Last updated
08/14/2020
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