Individual
LUIS A VERGARA VILLAREAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 W OAKLAND PARK BLVD, OAKLAND PARK, FL 33311-1520
(754) 200-8248
(954) 400-5485
Mailing address
1807 SW 153RD PASS, MIAMI, FL 33185-5722
(786) 260-9845
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
22927
PR
208D00000X
General Practice Physician
Primary
ACN1560
FL
Other
Enumeration date
06/07/2023
Last updated
09/07/2023
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