Provider Demographics
NPI:1083732150
Name:VILLANUEVA-APONTE, JOSE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:VILLANUEVA-APONTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:GARDENIS B-3
Mailing Address - Street 2:EXTENSION CAMPO ALEGRE
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-269-3892
Mailing Address - Fax:787-767-3968
Practice Address - Street 1:HOSPITAL INDUSTRIAL-CENTRO MEDICO
Practice Address - Street 2:BO. MOANACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-754-2525
Practice Address - Fax:787-767-3968
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR25282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10450OtherSTATE LICENSE
JV2934924OtherFEDERAL NARCOTICS LICENSE
PRBV09946-5OtherSTATE NARCOTICS LICENSE
PR0082884Medicare ID - Type Unspecified
PRBV09946-5OtherSTATE NARCOTICS LICENSE