Individual
MRS. TINA MARIE VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
936 PRESTIGE LN, PEARL, MS 39208-9108
(646) 829-8141
Mailing address
936 PRESTIGE LN, PEARL, MS 39208-9108
(646) 829-8141
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
916859
MS
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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