Individual
JUAN B VILLAVICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
HOSPITAL RYDER MEMORIAL, HUMACAO, PR 00792
(787) 852-0768
Mailing address
PO BOX 4960, CAGUAS, PR 00726-4960
(787) 396-6658
(787) 852-8248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8317
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060172
CRUZ AZUL
PR
01
—
10381
INTERNATIONAL MEDICAL CAR
PR
01
—
3549
PREFFERED MEDICARE CHOICE
PR
01
—
6240098
HUMANA HEALTH PLANS
PR
01
—
82349
TRIPLE S
PR
01
—
992181
MEDICARE Y MUCHO MAS
PR
Enumeration date
11/28/2005
Last updated
03/02/2017
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