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NPI Code Detail

MEDICARE: JORGE RAMON VILLARREAL M.D.

MEDICARE: JORGE RAMON VILLARREAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianME0054730FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093742413
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE RAMON VILLARREAL M.D.
Provider Business Mailing Address
First Line : PO BOX 22201
Second Line :
City : TAMPA
State : FL
Zip : 33622-2201
Country : US
Telephone Number : 317-614-9863
Fax Number : 844-876-0873
Provider Business Practice Location Address
First Line : 2400 DUNDEE RD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-1166
Country : US
Telephone Number : 317-614-9863
Fax Number : 844-876-0873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 02/14/2022

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