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General NPI Number Information
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NPI Number | 1457710014
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Entity Type | Organization
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Legal Business Name | VILLEGAS LLC
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 360 CALLE DEL PARQUE SUITE 1 CIUDADELA SUITE 1
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City | SAN JUAN
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State | PR
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Zip | 00912-0001
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Country | US
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Telephone | 787-919-3156
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Fax | 787-919-3156
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Provider Business Mailing Address
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Address Line | 360 CALLE DEL PARQUE STE 1 CIUDADELA
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-919-3156
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Fax | 787-919-3156
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR M VILLEGAS CEIDE
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Credential | M.D.
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Telephone | 787-919-3156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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