Provider Demographics
NPI:1700691599
Name:VILLANUEVA GONZALEZ, ROSA ALEJANDRA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:ALEJANDRA
Last Name:VILLANUEVA GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 26290
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9405
Mailing Address - Country:US
Mailing Address - Phone:787-936-4641
Mailing Address - Fax:
Practice Address - Street 1:A33 AVE MAGNOLIA
Practice Address - Street 2:VILLA CONTESSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-2637
Practice Address - Country:US
Practice Address - Phone:787-936-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1388225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist