Provider Demographics
NPI:1396012522
Name:HUNALDO J. VILLALOBOS, M.D., P.A.
Entity Type:Organization
Organization Name:HUNALDO J. VILLALOBOS, M.D., P.A.
Other - Org Name:CENTRAL FLORIDA NEUROSURGERY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTH OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HUNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-288-8638
Mailing Address - Street 1:801 N ORANGE AVE
Mailing Address - Street 2:SUITE 720
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1026
Mailing Address - Country:US
Mailing Address - Phone:407-288-8638
Mailing Address - Fax:407-288-8639
Practice Address - Street 1:801 N ORANGE AVE
Practice Address - Street 2:SUITE 720
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1026
Practice Address - Country:US
Practice Address - Phone:407-288-8638
Practice Address - Fax:407-288-8639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 94953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005526000Medicaid
FL005526000Medicaid