Healthcare Provider Details

I. General information

NPI: 1558774729
Provider Name (Legal Business Name): EUGENIO VILLARREAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 SHERIDAN ST STE 101
HOLLYWOOD FL
33021-3633
US

IV. Provider business mailing address

3475 SHERIDAN ST STE 101
HOLLYWOOD FL
33021-3633
US

V. Phone/Fax

Practice location:
  • Phone: 954-391-9995
  • Fax: 954-391-9949
Mailing address:
  • Phone: 954-391-9995
  • Fax: 954-391-9949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number289017
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME162890
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberW1917
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME162890
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: