Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 9320035 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 9320035 | FL |
NPI | 1043754161 |
---|---|
Provider Name | Nelson Villar |
First Address | Tampa, FL 33624-5834 |
Second Address | Tampa, FL 33612-3415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2016 |
Last Update Date | 08/12/2016 |