Provider Demographics
NPI:1770564171
Name:YU, ANTONIO VILLAMOR JR (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:VILLAMOR
Last Name:YU
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:13945 W GRAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2437
Practice Address - Country:US
Practice Address - Phone:623-556-2252
Practice Address - Fax:623-556-2262
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2025-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23004207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ495805Medicaid
Z70255Medicare ID - Type UnspecifiedGROUP
AZ495805Medicaid
F60571Medicare UPIN