Individual
ANTONNETTE VILLAFLOR-ZITOUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
721 FAIRFAX AVE, 3RD FLOOR, NORFOLK, VA 23507-2007
(757) 446-5915
(757) 446-5969
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5915
(757) 446-5969
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110002435
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-017
TRICARE/CHAMPUS
VA
01
—
10014991P
SENTARA OPTIMA
VA
01
—
10019320P
SENTARA/OPTIMA
VA
05
—
1609932318
—
VA
05
—
8101070
—
NC
01
—
PAR
MULTIPLAN
VA
Enumeration date
12/28/2006
Last updated
01/04/2012
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