Provider Demographics
NPI:1750184776
Name:VILLARREAL PINTO, CARLOS ANTONIO SR
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ANTONIO
Last Name:VILLARREAL PINTO
Suffix:SR
Gender:
Credentials:
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:ANTONIO
Other - Last Name:VILLARREAL
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:CALLE 5 OESTE VIA ESTUDIANTE
Mailing Address - Street 2:77
Mailing Address - City:VOLCAN TIERRAS ALTAS
Mailing Address - State:CHIRIQUI
Mailing Address - Zip Code:40424
Mailing Address - Country:PA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE 5 OESTE VIA ESTUDIANTE
Practice Address - Street 2:77
Practice Address - City:VOLCAN TIERRAS ALTAS
Practice Address - State:CHIRIQUI
Practice Address - Zip Code:40424
Practice Address - Country:PA
Practice Address - Phone:541-246-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1143207Q00000X
FL1153207T00000X
OR1142204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery