ENRIQUE VILLA MD PA
Ambulatory Health at 3 St, Miami, FL

License number
Florida ME114775
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. ENRIQUE VILLA MD
Title: OWNER/PRESIDENT
Phone: (305) 343-6655
Address
Address
7221 NW 3Rd St, Miami, FL 33126
National Provider ID: 1134460355
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ENRIQUE VILLA, M.D., PA

Miami, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Feb 12, 2013
Inactive since:
Sep 26, 2014
Addresses:
7221 NW 3, Miami, FL 33126 (Physical)
7221 NW 3 St, Miami, FL 33126
State ID:
P13000014430
Business type:
Florida Profit Corporation
Director, Vice Presidents:
Enrique Villa Director, President, inactive, 7221 NW 3, Miami, FL 33126 (Physical),Rosa M Veliz Director, Vice President, inactive, 7221 NW 3, Miami, FL 33126 (Physical)
Agent:
Villa, Enrique,7221 NW 3, Miami, FL 33126 (Physical)
EIN:
NONE

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