Healthcare Provider Details

I. General information

NPI: 1518180579
Provider Name (Legal Business Name): MADEL VILLEGAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUNNY ISLES SHOPPING CENTER SPACE 123A
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

4605 TUTU PARK MALL SUITE 207
ST THOMAS VI
00802-1736
US

V. Phone/Fax

Practice location:
  • Phone: 340-202-0084
  • Fax: 340-202-0085
Mailing address:
  • Phone: 340-775-3700
  • Fax: 340-714-3904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1762
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRS2005-0360
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: