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NPI Code Detail

MEDICARE: DR. JONATHAN VILLAS DELA LUNA M.D.

MEDICARE: DR. JONATHAN VILLAS DELA LUNA M.D.
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
12084P0800XPsychiatry PhysicianMD14529RI

General Provider Information

NPI Number : 1649591421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN VILLAS DELA LUNA M.D.
Provider Business Mailing Address
First Line : 2180 MENDON RD STE 21
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-3825
Country : US
Telephone Number : 401-333-3810
Fax Number :
Provider Business Practice Location Address
First Line : 2180 MENDON RD STE 21
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-3825
Country : US
Telephone Number : 401-333-3810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2010
Last Update Date : 03/17/2018

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