MEDICARE: DR. ISRAEL VILLANUEVA JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	215544	NY
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME128453	FL
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	14327	NV
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	336494	LA
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	A79307	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	VA681	OTHER	FL	MEDICARE HF

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134297161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ISRAEL VILLANUEVA JR. MD

Provider Business Mailing Address
First Line	:	14320 VENTURA BLVD # 308
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-2717
Country	:	US
Telephone Number	:	323-920-9377
Fax Number	:	805-832-6487

Provider Business Practice Location Address
First Line	:	2200 N COMMERCE PKWY STE 200
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-3258
Country	:	US
Telephone Number	:	239-209-3773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	10/30/2025

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