Organization
PALM BEACH CARDIOVASCULAR CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTO ERNESTO VILLA M.D. (PRESIDENT)
(561) 627-2210
Entity
Organization
Contact information
Practice address
3385 BURNS RD, SUITE 108, PALM BEACH GARDENS, FL 33410-4328
(561) 627-2210
(561) 627-2210
Mailing address
600 UNIVERSITY BLVD, SUITE 200, JUPITER, FL 33458-2778
(561) 627-2210
(561) 627-2130
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME50208
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21776
MEDICARE NUMBER
FL
Enumeration date
12/03/2007
Last updated
02/04/2008
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