Provider Demographics
NPI:1619986767
Name:VILLAFANE-CANDELAS, IVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:IVONNE
Middle Name:
Last Name:VILLAFANE-CANDELAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190110
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-0110
Mailing Address - Country:US
Mailing Address - Phone:787-763-0550
Mailing Address - Fax:787-763-1093
Practice Address - Street 1:CENTRO MEDICO, CARR. 22 KM 2
Practice Address - Street 2:CENTRO PEDIATRICO HOSPITAL PEDIATRICO UNIVERSITARIO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-763-0550
Practice Address - Fax:787-763-1093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6356208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics