Provider Demographics
NPI:1710021266
Name:SANCHEZ VILLANUEVA, OMAR ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:ALEJANDRO
Last Name:SANCHEZ VILLANUEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-415-1546
Mailing Address - Fax:251-415-1026
Practice Address - Street 1:1700 CENTER ST
Practice Address - Street 2:PICU
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3301
Practice Address - Country:US
Practice Address - Phone:251-415-1546
Practice Address - Fax:251-415-1026
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1138372080P0203X, 208000000X
AL324662080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics