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General NPI Number Information
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NPI Number | 1508934555
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Entity Type | Individual
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Provider Name | LEONARDO VILLEGAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 730 BAYFRONT PKWY STE 5A
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City | PENSACOLA
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State | FL
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Zip | 32502-6250
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Country | US
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Telephone | 850-432-5488
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Fax | 850-432-5228
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Provider Business Mailing Address
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Address Line | 4205 BELFORT RD STE 4015
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City | JACKSONVILLE
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State | FL
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Zip | 32216-3623
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Country | US
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Telephone | 904-450-6014
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Fax | 904-450-6401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2009-01041
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | ME110757
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License Number State | FL
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