Provider Demographics
NPI:1336308485
Name:VILLANUEVA, CAROLINA PAULA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:PAULA
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1000 5TH STREET
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:305-532-1164
Practice Address - Street 1:240 CRANDON BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149
Practice Address - Country:US
Practice Address - Phone:305-361-6232
Practice Address - Fax:305-365-0031
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME963372080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003341500Medicaid