Doctor Name: | MRS. WANDA I VILLANUEVA GONZALEZ |
NPI Number: | 1477673762 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | ACN706 |
Business Practice Address: | 900 Towne Center Dr Kissimmee, FL - 347593470 |
Business Phone Number: | 4079310444 |
Business Fax Number: | 4079624446 |
Mailing Address: | 931 W Oak St, Ste 103 KISSIMMEE |
State: | FL |
Postal Code: | 347414973 |
Phone Number: | 4079310444 |
Fax Number: | 4079624446 |
NPI Enumeration Date: | 03/30/2007 |
NPI Last Update Date: | 08/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ACN706 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |