Provider Demographics
NPI:1215490719
Name:VILLA, NATALIA ANDREA (COTA)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:ANDREA
Last Name:VILLA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 SW 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5626
Mailing Address - Country:US
Mailing Address - Phone:954-600-7732
Mailing Address - Fax:
Practice Address - Street 1:4301 S FLAMINGO RD STE 101
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-1902
Practice Address - Country:US
Practice Address - Phone:954-312-3449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-11
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist