Healthcare Provider Details

I. General information

NPI: 1578510889
Provider Name (Legal Business Name): ANDREW PETER VILLAMAGNA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 S PARSONS AVE STE 120
BRANDON FL
33511-5252
US

IV. Provider business mailing address

1317 EDGEWATER DR # 890
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 813-443-3399
  • Fax: 813-381-3398
Mailing address:
  • Phone: 727-709-1749
  • Fax: 813-821-9782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 103904
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: