Jose L Villacob

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11004600 Issued in FL

Practice address

10425 SW 112TH Ave Apt 309
Miami, FL 33176-8214

Phone

(786) 234-8308

NPI assigned

Dec 1, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Unimed Medical Centers LLC

  • Family Medicine Physician
  • Miami Lakes, FL
  • NPI 1124777545
  Medicare reassignment

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1255936910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10425 SW 112TH AVE APT 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 SW 112TH AVE APT 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331768214",
            "telephone_number": "786-234-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACOB",
        "first_name": "JOSE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11004600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9465314374",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Vanessa Villabona, M.D.
• Villacian Theraphy Center, Inc
• Eugene Villacian
• Fernando Villacian, MD
• Tiffany Paola Villacis
• Vanessa Villacorta Sierra, M.D.
• Angela Villada, COTA/L
• Gabriel Villada, M.D.
• Yamila Villaescusa
• Mei-Ling Villafana Abraham

• Family Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.