Individual
NOSTER VILLAMOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
123 US 27 S, LAKE PLACID, FL 33852-7918
(863) 465-4412
(863) 465-7790
Mailing address
123 US 27 S, LAKE PLACID, FL 33852-7918
(863) 465-4412
(863) 465-7790
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT7249
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00907877
RAILROAD MC
FL
01
—
Y7382
BLUECROSS/BLUESHIELD OF FLORIDA
FL
Enumeration date
09/15/2009
Last updated
12/01/2015
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