Organization
CORAL J VILLANUEVA DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORAL J VILLANUEVA DPM (PRESIDENT)
(786) 859-3509
Entity
Organization
Contact information
Practice address
1090 KANE CONCOURSE, SUITE 204, BAY HARBOR ISLANDS, FL 33154-2130
(305) 893-9366
(305) 893-4408
Mailing address
6540 NW 114TH AVE, APT 1403, DORAL, FL 33178-4587
(786) 859-3509
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
PO3285
FL
Other
Enumeration date
01/29/2008
Last updated
11/04/2008
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