Provider Demographics
NPI:1740522663
Name:VILCHES-OLIVERA, ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:VILCHES-OLIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:VILCHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9195 SW 72ND ST STE 120B
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3488
Mailing Address - Country:US
Mailing Address - Phone:305-901-5522
Mailing Address - Fax:305-901-1513
Practice Address - Street 1:9195 SW 72ND ST STE 120B
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3488
Practice Address - Country:US
Practice Address - Phone:305-901-5522
Practice Address - Fax:305-901-1513
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC12-0000049207R00000X
FLME128057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine