Individual provider Active NPI

Israel Villanueva

  • Physical Therapy Assistant
  • Naples, FL
National Provider Identifier
1740747609
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
18517 Issued in FL
Practice address
4750 Aston Gardens Way
Naples, FL 34109-3594
Phone
(239) 254-6290
NPI assigned
Feb 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 18517 FL Primary

Addresses

Primary practice location

4750 Aston Gardens Way
Naples, FL 34109-3594

Mailing address

27299 Riverview Center Blvd Ste 201
Bonita Springs, FL 34134-4322

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

LicenseStateTypeSpecialty
18517FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1740747609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27299 RIVERVIEW CENTER BLVD STE 201",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 ASTON GARDENS WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341093594",
            "telephone_number": "239-254-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ISRAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-27",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "18517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.