Active NPI
Pedro Raul Villanueva, M.D.
- Pediatrics Physician
- Arcadia, FL
National Provider Identifier
1851459606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME50602
- Practice address
- 888 N Robert Ave
Arcadia, FL 34266-9580 - Phone
- (863) 494-8410
- Fax
- (863) 491-5306
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME50602 | FL | Primary |
Addresses
Primary practice location
888 N Robert Ave
Arcadia, FL 34266-9580
Mailing address
700 8TH Ave W
Ste 101
Palmetto, FL 34221-4737
Phone (941) 776-4008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046388400 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME50602 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCR Health, Inc. | Past | Accepting new patients |
Interoperability endpoints
- pedro.villanueva.1@11352.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1851459606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 8TH AVE W",
"address_2": "STE 101",
"city": "PALMETTO",
"state": "FL",
"postal_code": "342214737",
"telephone_number": "941-776-4008",
"fax_number": "941-845-4963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 N ROBERT AVE",
"city": "ARCADIA",
"state": "FL",
"postal_code": "342669580",
"telephone_number": "863-494-8410",
"fax_number": "863-491-5306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "PEDRO",
"middle_name": "RAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME50602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046388400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, FL
- Robert Joseph Vaughn, LCSW
- Mirna Alejandra Velasquez, LCSW, CTS
- Shweta R Venkat, M.D.
- Terence Ryan Vereen, APRN
- Kaydean J Vickers, FNP
- Amanda Waggoner, PSY.D
- Tracey Nicole Waite, LCSW
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0811)
- Wal-Mart Stores East, LP (Vision Center 30-0811)
- Walgreen Co (Walgreens #10668)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.