Individual provider · Type 1 NPI
Alexandra Villalba, PA
Surgical Physician Assistant · Bristol, CT
NPI number
1114576436
Active
Practice location
240 Main St
Bristol, CT 06010-6337
Mailing address
13732 NW 16th St
Pembroke Pines, FL 33028-3037
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | None listed |
| Medical Physician Assistant | 363AM0700X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | None listed |
Surgical Physician Assistant: Definition to come...
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About NPI 1114576436
Alexandra Villalba, PA's National Provider Identifier is 1114576436, issued on Sep 9, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bristol, CT. The record was last updated on Sep 9, 2019.