Individual provider · Type 1 NPI

Gabriel Leo Villavicencio, MD

Student in an Organized Health Care Education/Training Program · Las Vegas, NV

NPI number 1679374979 Active

Practice location

4505 S Maryland Pkwy
Las Vegas, NV 89154-9900

Call (702) 855-3011 Map

Mailing address

1077 S Johnson St
Lakewood, CO 80226-4072

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1679374979

Gabriel Leo Villavicencio, MD's National Provider Identifier is 1679374979, issued on Mar 22, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Las Vegas, NV. The record was last updated on Mar 22, 2025.