Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME 95466 | FL |
NPI | 1104986892 |
---|---|
Provider Name | Kathryn Slott Villano |
First Address | Sunrise, FL 33323-2815 |
Second Address | Jacksonville, FL 32207-8334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 09/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001479500 | (05) | FL |