Individual
LUIS GUILLERMO CHAVES VILLAMIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E OAKLAND PARK BLVD, STE 210, OAKLAND PARK, FL 33334-4400
(954) 561-6222
(954) 990-7650
Mailing address
540 BRICKELL KEY DR, #1226, MIAMI, FL 33131-2697
(786) 879-2816
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME115744
FL
2084P0802X
Addiction Psychiatry Physician
ME115744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013193800
—
FL
01
—
HX727Z
MEDICARE PTAN
FL
Enumeration date
04/01/2009
Last updated
12/06/2014
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