Provider Demographics
NPI:1427147370
Name:VILLANUEVA, AIDA N (MD)
Entity type:Individual
Prefix:DR
First Name:AIDA
Middle Name:N
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:F-22 HUCAR ST.
Mailing Address - Street 2:COLINAS DE GUAYNABO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-272-9404
Mailing Address - Fax:787-272-9404
Practice Address - Street 1:F22 CALLE HUCAR
Practice Address - Street 2:COLINAS DE GUAYNABO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6212
Practice Address - Country:US
Practice Address - Phone:787-272-9404
Practice Address - Fax:787-272-9404
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11135173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine