MEDICARE: VILLANUEVA GONZALEZ AND ASSOCIATES, PSC

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	261QC1800X	Corporate Health Clinic/Center	14440	PR

General Provider Information

NPI Number	:	1730303991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLANUEVA GONZALEZ AND ASSOCIATES, PSC

Provider Business Mailing Address
First Line	:	HC 2 BOX 3014
Second Line	:
City	:	SABANA HOYOS
State	:	PR
Zip	:	00688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	CARR #2 KM 65.9 BO SANTANA
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612
Country	:	US
Telephone Number	:	787-650-6640
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	MRS. WANDA I VILLANUEVA GONZALEZ
Credential	:
Telephone Number	:	787-650-6640

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	08/22/2020

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