Provider Demographics
NPI:1528002714
Name:VILLANEUVO, LUZVIMINDA ALLARDE (MD)
Entity Type:Individual
Prefix:DR
First Name:LUZVIMINDA
Middle Name:ALLARDE
Last Name:VILLANEUVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUZVIMINDA
Other - Middle Name:ALLARDE
Other - Last Name:OLIVERIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20661 NED LOVE AVE
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34431-6767
Mailing Address - Country:US
Mailing Address - Phone:352-489-2401
Mailing Address - Fax:352-489-2521
Practice Address - Street 1:20661 NED LOVE AVE
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34431-6767
Practice Address - Country:US
Practice Address - Phone:352-489-2401
Practice Address - Fax:352-489-2521
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47193173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73254Medicare ID - Type Unspecified
FLD86268Medicare UPIN