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General NPI Number Information
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NPI Number | 1730380197
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Entity Type | Individual
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Provider Name | VIVIAN D. ANGULO VILLANUEVA MD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 6703 38TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1536
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Country | US
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Telephone | 727-213-5377
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Fax | 727-828-9639
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Provider Business Mailing Address
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Address Line | PO BOX 850001, DEPT 8340
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City | ORLANDO
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State | FL
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Zip | 32885-0001
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Country | US
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Telephone | 855-536-7277
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Fax | 855-830-1722
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 13973
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME138724
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License Number State | FL
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