Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 133367 | NC |
N | 208600000X | Surgeon | 133367 | NC |
Y | 208200000X | Surgeon | ME120318 | FL |
Y | 208600000X | Surgeon | ME120318 | FL |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 251016 | MA |
NPI | 1013174101 |
---|---|
Provider Name | Dr. Nestor Ricardo Villamizar |
First Address | Miami, FL 33136-1002 |
Second Address | Miami, FL 33136-1002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2008 |
Last Update Date | 12/06/2014 |