Provider Demographics
NPI:1578510889
Name:VILLAMAGNA, ANDREW PETER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PETER
Last Name:VILLAMAGNA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2298
Mailing Address - Country:US
Mailing Address - Phone:727-584-7706
Mailing Address - Fax:727-588-9287
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2298
Practice Address - Country:US
Practice Address - Phone:727-584-7706
Practice Address - Fax:727-588-9287
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 103904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001034100Medicaid
FL2115144OtherCOVENTRY
FL146MROtherFLORIDA BLUE