Healthcare Provider Details

I. General information

NPI: 1396012522
Provider Name (Legal Business Name): HUNALDO J. VILLALOBOS, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2011
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N ORANGE AVE SUITE 720
ORLANDO FL
32801-1026
US

IV. Provider business mailing address

801 N ORANGE AVE SUITE 720
ORLANDO FL
32801-1026
US

V. Phone/Fax

Practice location:
  • Phone: 407-288-8638
  • Fax: 407-288-8639
Mailing address:
  • Phone: 407-288-8638
  • Fax: 407-288-8639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME 94953
License Number StateFL

VIII. Authorized Official

Name: HUNALDO VILLALOBOS
Title or Position: AUTH OFFICIAL
Credential: MD
Phone: 407-288-8638