Individual
MAURICIO A. VILLAVICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
264532
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
1015
MN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
264532
MA
Other
Enumeration date
12/09/2014
Last updated
06/12/2025
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