Basic Information
| Provider Information | |||||||||
| NPI: | 1104575380 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VILLANUEVA | ||||||||
| FirstName: | HECTOR | ||||||||
| MiddleName: | REY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 7 BOX 32559 | ||||||||
| Address2: | |||||||||
| City: | HATILLO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006599603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874522515 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CARRETERA 129, KM 1.0 AVENIDA SAN LUIS | ||||||||
| Address2: | |||||||||
| City: | ARECIBO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876507272 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2022 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 22931 | PR | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.