Individual
DR. EVA VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 HEALTH PARK BLVD STE 300, ST AUGUSTINE, FL 32086-5784
(904) 819-4082
(904) 819-5156
Mailing address
1765 SAN MARCO BLVD APT 1, JACKSONVILLE, FL 32207-1027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125066046
IL
207Q00000X
Family Medicine Physician
Primary
ME132602
FL
208M00000X
Hospitalist Physician
ME132602
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IWUAZ
BLUE CROSS
FL
Enumeration date
07/12/2014
Last updated
06/16/2021
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