Provider Demographics
NPI:1124075296
Name:VILLANO, KATHRYN LOTSPEICH (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LOTSPEICH
Last Name:VILLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:LOTSPEICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2666 TIGERTAIL AVE
Mailing Address - Street 2:#108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4694
Mailing Address - Country:US
Mailing Address - Phone:305-856-6470
Mailing Address - Fax:305-856-6470
Practice Address - Street 1:2666 TIGERTAIL AVE
Practice Address - Street 2:#108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4694
Practice Address - Country:US
Practice Address - Phone:305-856-6470
Practice Address - Fax:305-856-6470
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL83205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine