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Individual
GENESIS B VILLANUEVA
Active
Individual
GENESIS B VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT27082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01016039
RR MEDICARE
FL
Enumeration date
01/13/2012
Last updated
02/04/2015
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