Individual
NELSON MEDINA VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3480 POLYNESIAN ISLE BLVD, KISSIMMEE, FL 34746-4654
(877) 352-5864
Mailing address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-6639
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17747
PR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME119501
FL
Other
Enumeration date
01/24/2010
Last updated
04/01/2026
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