Provider Demographics
NPI:1366543787
Name:ALBINO, JUAN A (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:A
Last Name:ALBINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N US HIGHWAY 441
Mailing Address - Street 2:BLDG 940 SUITE 942
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-8975
Mailing Address - Country:US
Mailing Address - Phone:352-751-4955
Mailing Address - Fax:888-716-2004
Practice Address - Street 1:1400 N US HIGHWAY 441
Practice Address - Street 2:BLDG 940 SUITE 942
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8975
Practice Address - Country:US
Practice Address - Phone:352-751-4955
Practice Address - Fax:888-716-2004
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81374207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58002OtherBCBS OF FL PROVIDER #
FLME81374OtherSTATE LICENSE #
FLME81374OtherSTATE LICENSE #
FLME81374OtherSTATE LICENSE #
FL58002ZMedicare ID - Type Unspecified
FLB76527Medicare UPIN