Individual
BENJAMIN R VILLALBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14875 NW 77TH AVENUE, SUITE #100, MIAMI LAKES, FL 33014
(305) 822-2380
(305) 824-0665
Mailing address
1155 SAN PEDRO AVENUE, CORAL GABLES, FL 33156
(305) 667-0805
(305) 667-7731
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 33974
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069249200
—
FL
Enumeration date
05/02/2007
Last updated
04/26/2013
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