Basic Information
Provider Information
NPI: 1225569049
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BILLIG
FirstName: VICTORIA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8600 SW 92ND ST STE 204B
Address2:  
City: MIAMI
State: FL
PostalCode: 331567377
CountryCode: US
TelephoneNumber: 3059287249
FaxNumber:  
Practice Location
Address1: 5000 W OAKLAND PARK BLVD
Address2:  
City: LAUDERDALE LAKES
State: FL
PostalCode: 333131585
CountryCode: US
TelephoneNumber: 9547356000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2017
LastUpdateDate: 04/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X FLN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RC0200XOS15962FLY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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