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General NPI Number Information
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NPI Number | 1770805400
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Entity Type | Individual
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Provider Name | JUVY C. VILLANUEVA DPT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 322 NE 47TH PL
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City | POMPANO BEACH
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State | FL
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Zip | 33064
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Country | US
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Telephone | 561-563-4846
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Fax |
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Provider Business Mailing Address
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Address Line | 322 NE 47TH PL
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City | POMPANO BEACH
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State | FL
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Zip | 33064-4104
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Country | US
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Telephone | 561-563-4846
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Fax |
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 18066
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 019621
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License Number State | NY
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