Active NPI
Heidi Villanueva Udang
- Physical Therapist
- Lakeland, FL
National Provider Identifier
1457635369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26253
- Practice address
- 4141 Lakeland Hills Blvd
Lakeland, FL 33805-1978 - Phone
- (863) 937-8070
- NPI assigned
- Oct 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT26253 | FL | Primary |
Addresses
Primary practice location
4141 Lakeland Hills Blvd
Lakeland, FL 33805-1978
Mailing address
5115 N Socrum Loop Rd
Apt 435
Lakeland, FL 33809-4288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT26253 | FL | MD | Physical Therapist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1457635369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5115 N SOCRUM LOOP RD",
"address_2": "APT 435",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338094288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4141 LAKELAND HILLS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338051978",
"telephone_number": "863-937-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UDANG",
"first_name": "HEIDI",
"middle_name": "VILLANUEVA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-11",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.