Organization
PALM BEACH CARDIOVASCULAR CLINIC LLC
Active
Parent organization
PALM BEACH CARDIOVASCULAR CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALM BEACH CARDIOVASCULAR CLINIC LLC
Authorized official
DR. AUGUSTO ERNESTO VILLA M.D. (PRESIDENT)
(561) 627-2210
Entity
Organization
Contact information
Practice address
601 UNIVERSITY BLVD, SUITE 206, JUPITER, FL 33458-2788
(561) 627-2210
(561) 627-5850
Mailing address
601 UNIVERSITY BLVD, SUITE 206, JUPITER, FL 33458-2788
(561) 627-2210
(561) 627-5850
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21776
FL
207RC0001X
Clinical Cardiac Electrophysiology Physician
21776
FL
207RI0011X
Interventional Cardiology Physician
21776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21776
MEDICARE NUMBER
FL
Enumeration date
07/20/2007
Last updated
07/20/2007
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