Individual provider Active NPI

Diego Andres Villalba, PHARM.D.

  • Pharmacist
  • Seminole, FL
National Provider Identifier
1114356771
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS51055 Issued in FL
Practice address
10121 Seminole Blvd
Seminole, FL 33772-2543
Phone
(727) 398-7308
NPI assigned
Nov 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS51055 FL Primary

Addresses

Primary practice location

10121 Seminole Blvd
Seminole, FL 33772-2543

Mailing address

8520 75TH Ave
Seminole, FL 33777-4434
Phone (575) 590-4397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS51055FLMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1114356771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8520 75TH AVE",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774434",
            "telephone_number": "575-590-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10121 SEMINOLE BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722543",
            "telephone_number": "727-398-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALBA",
        "first_name": "DIEGO",
        "middle_name": "ANDRES",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS51055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.