Villanueva Gonzalez, Wanda I

Villanueva Gonzalez, Wanda I is an individual health care provider with primary practice located at 1305 N Orange Ave , Green Cove Springs FL 32043-2547. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Villanueva Gonzalez, Wanda I can be contacted via phone (904) 284-5904.

Contact Information

Primary practice address
1305 N Orange Ave Green Cove Springs FL 32043-2547
Fax: (904) 284-5905
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X ACN706 Florida

Profile Details

NPI number 1477673762
LBN Legal business name Villanueva Gonzalez, Wanda I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2007
Last updated Apr 12th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477673762 NPPES
Florida Other IH341Z FLORIFA MEDICARE
Florida MEDICAID 015593700 FLORIFA MEDICARE

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