Individual provider Active NPI

Albert Villanueva-Reyes, EDD, MSC, CCC-SLP

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1902033962
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
473 Issued in PR
Practice address
2674 Simpson Rd
Kissimmee, FL 34744-4674
Phone
(407) 408-2300
Fax
(866) 697-7393
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15857 FL
Speech-Language Pathologist 235Z00000X 473 PR Primary

Addresses

Primary practice location

2674 Simpson Rd
Kissimmee, FL 34744-4674

Mailing address

2674 Simpson Road
Kissimmee, FL 34744-0001
Phone (787) 461-3700

Other identifiers 1

IdentifierTypeStateIssuer
473OtherPRPROFESSIONAL LICENSE

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
15857FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1902033962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2674 SIMPSON ROAD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347440001",
            "telephone_number": "787-461-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 SIMPSON RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444674",
            "telephone_number": "407-408-2300",
            "fax_number": "866-697-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA-REYES",
        "first_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "EDD, MSC, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "15857",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "473",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.