Individual
LEONARDO VILLEGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 BAYFRONT PKWY STE 5A, PENSACOLA, FL 32502-6250
(850) 432-5488
(850) 432-5228
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6014
(904) 450-6401
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2009-01041
NC
2086X0206X
Surgical Oncology Physician
Primary
ME110757
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003997200
—
FL
01
—
14FC8
BCBSFL
FL
01
—
592-21627
BCBS
AL
Enumeration date
11/30/2006
Last updated
02/21/2020
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