Organization
PALM BEACH CARDIOVASCULAR CLINIC LLC
Active
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
Update your record
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