Healthcare Provider Details

I. General information

NPI: 1053501411
Provider Name (Legal Business Name): NADYA YANUSKA VILLALBA-RAMOS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 CALLE DR PAVIA FERNANDEZ PAVIA MEDICAL PLAZA SUITE 209
SANTURCE PR
00909-2244
US

IV. Provider business mailing address

436 CALLE REY LUIS LA VILLA DE TORRIMAR
GUAYNABO PR
00969-3170
US

V. Phone/Fax

Practice location:
  • Phone: 787-728-2318
  • Fax: 787-728-2359
Mailing address:
  • Phone: 787-366-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number17876
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number17876
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: