Individual
GABRIEL LEO VILLAVICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4505 S MARYLAND PKWY, LAS VEGAS, NV 89154-9900
(702) 855-3011
Mailing address
1077 S JOHNSON ST, LAKEWOOD, CO 80226-4072
(303) 378-0208
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2025
Last updated
03/22/2025
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