Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. LUIS ANTONIO CACERES VILLALTA, M.D.
ActiveMR. LUIS ANTONIO CACERES VILLALTA, M.D. is a Adolescent Medicine healthcare provider located in CORONA, New York. NPI 1053803742 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine · CORONA, NY
Registration Details
- NPI Number
- 1053803742
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 30, 2018 (8.22931153185 yrs)
- Last Updated
- Jul 7, 2021
- License
-
310925-01 (NY)
Practice Information
- Address
-
3716 108TH STCORONA, NY, 113682025Browse NY providers · Browse ZIP 11368
- Phone
- 7186514000
- Primary Specialty
-
Adolescent Medicine
207QA0505X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.