Organization
ANDRES R VILLAR MD
Active
Other names
Childrens Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRES R VILLAR MD (ADMINISTRATOR)
(386) 755-5044
Entity
Organization
Contact information
Practice address
1002 11TH ST SW, LIVE OAK, FL 32064-3606
(386) 364-8050
Mailing address
PO BOX 606, GLEN ST MARY, FL 32040-0606
(386) 755-5044
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370861607
—
FL
Enumeration date
08/16/2021
Last updated
03/07/2022
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