Provider Demographics
NPI:1033483557
Name:CAROLINA VILLANUEVA, M.D., P.A.
Entity Type:Organization
Organization Name:CAROLINA VILLANUEVA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-399-6028
Mailing Address - Street 1:1000 5TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6508
Mailing Address - Country:US
Mailing Address - Phone:786-399-6028
Mailing Address - Fax:
Practice Address - Street 1:1000 5TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6508
Practice Address - Country:US
Practice Address - Phone:786-399-6028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME963372080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty