1053501411 NPI number — NADYA YANUSKA VILLALBA-RAMOS M.D.

Table of content: NADYA YANUSKA VILLALBA-RAMOS M.D. (NPI 1053501411)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053501411 NPI number — NADYA YANUSKA VILLALBA-RAMOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VILLALBA-RAMOS
Provider First Name:
NADYA
Provider Middle Name:
YANUSKA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053501411
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
436 CALLE REY LUIS
Provider Second Line Business Mailing Address:
LA VILLA DE TORRIMAR
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-3170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-366-5551
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
611 CALLE DR PAVIA FERNANDEZ
Provider Second Line Business Practice Location Address:
PAVIA MEDICAL PLAZA SUITE 209
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-2244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-728-2318
Provider Business Practice Location Address Fax Number:
787-728-2359
Provider Enumeration Date:
07/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QS0132X , with the licence number:  17876 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 17876 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com