Provider Demographics
NPI:1649258807
Name:VILLANUEVA, JOSE EUGENIO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:EUGENIO
Last Name:VILLANUEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSE
Other - Middle Name:EUGENIO
Other - Last Name:VILLANUEVA-ARCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1379 PASEO DON JUAN
Mailing Address - Street 2:APT. 9C
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1461
Mailing Address - Country:US
Mailing Address - Phone:787-765-2741
Mailing Address - Fax:787-724-6626
Practice Address - Street 1:1056 AVE MUNOZ RIVERA
Practice Address - Street 2:STE 911
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5026
Practice Address - Country:US
Practice Address - Phone:787-765-2741
Practice Address - Fax:787-724-6626
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR41182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry