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Individual

DR. FABIO E. VILLEGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6101 OAK SHORE DR, SAINT CLOUD, FL 34771-8748
(407) 350-9499
Mailing address
6101 OAK SHORE DR, SAINT CLOUD, FL 34771-8748
(407) 350-9499

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME94636
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME 94636
FL
208D00000X
General Practice Physician
Primary
94636
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
274988200
FL
Enumeration date
03/09/2006
Last updated
12/27/2020
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