Villanueva Medical Group LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

ME98244 Issued in FL

Legal business name

VILLANUEVA MEDICAL GROUP LLC

Practice address

1451 NE 4TH Ave
Fort Lauderdale, FL 33304-1033

Phone

(954) 271-0135

Fax

(954) 271-0135

NPI assigned

Oct 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raul Villanueva, MDNPI 1265654263

Title

Owner

Phone

(954) 271-0135

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raul Villanueva, MD

  • Infectious Disease Physician
  • Fort Lauderdale, FL
  • NPI 1265654263
  Medicare reassignment NPD Authorized official
• Don D Fisher, D.O.

  • Family Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1396794699
  NPD (past)
• Melanie Rook, ARNP

  • Family Nurse Practitioner
  • Fort Lauderdale, FL
  • NPI 1528574092
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1609120666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 NE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041033",
            "telephone_number": "954-271-0135",
            "fax_number": "954-271-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 NE 4TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333041033",
            "telephone_number": "954-271-0135",
            "fax_number": "954-271-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLANUEVA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-271-0135",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME98244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME98244",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miguel Villacorta, D.O., MPH
• Stella Kocovic Villacorta, D.O.
• Village Group LLC
• Ricardo Donato Villalba, LAC
• Gloria L Villalobos
• Raul Villanueva, MD
• Suzette A Villard, RRT
• Annastacha Vilneus
• Shelly Vilsaint, LMT
• Benjamin Vinarski, DO

• Infectious Disease Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.