Provider Demographics
NPI:1821678962
Name:VILLAFLORES, SEAN MICHAEL ARRIETA (MD)
Entity type:Individual
Prefix:
First Name:SEAN MICHAEL
Middle Name:ARRIETA
Last Name:VILLAFLORES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEAN
Other - Middle Name:
Other - Last Name:VILLAFLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 419052
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-9052
Mailing Address - Country:US
Mailing Address - Phone:314-851-1000
Mailing Address - Fax:314-851-4445
Practice Address - Street 1:1027 BELLEVUE AVE STE 107
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-645-3743
Practice Address - Fax:314-647-7967
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024030784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine